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Sample records for vaccines longitudinal analysis

  1. Applied longitudinal analysis

    CERN Document Server

    Fitzmaurice, Garrett M; Ware, James H

    2012-01-01

    Praise for the First Edition "". . . [this book] should be on the shelf of everyone interested in . . . longitudinal data analysis.""-Journal of the American Statistical Association   Features newly developed topics and applications of the analysis of longitudinal data Applied Longitudinal Analysis, Second Edition presents modern methods for analyzing data from longitudinal studies and now features the latest state-of-the-art techniques. The book emphasizes practical, rather than theoretical, aspects of methods for the analysis of diverse types of lo

  2. Longitudinal categorical data analysis

    CERN Document Server

    Sutradhar, Brajendra C

    2014-01-01

    This is the first book in longitudinal categorical data analysis with parametric correlation models developed based on dynamic relationships among repeated categorical responses. This book is a natural generalization of the longitudinal binary data analysis to the multinomial data setup with more than two categories. Thus, unlike the existing books on cross-sectional categorical data analysis using log linear models, this book uses multinomial probability models both in cross-sectional and longitudinal setups. A theoretical foundation is provided for the analysis of univariate multinomial responses, by developing models systematically for the cases with no covariates as well as categorical covariates, both in cross-sectional and longitudinal setups. In the longitudinal setup, both stationary and non-stationary covariates are considered. These models have also been extended to the bivariate multinomial setup along with suitable covariates. For the inferences, the book uses the generalized quasi-likelihood as w...

  3. Bioinformatics analysis of Brucella vaccines and vaccine targets using VIOLIN.

    Science.gov (United States)

    He, Yongqun; Xiang, Zuoshuang

    2010-09-27

    Brucella spp. are Gram-negative, facultative intracellular bacteria that cause brucellosis, one of the commonest zoonotic diseases found worldwide in humans and a variety of animal species. While several animal vaccines are available, there is no effective and safe vaccine for prevention of brucellosis in humans. VIOLIN (http://www.violinet.org) is a web-based vaccine database and analysis system that curates, stores, and analyzes published data of commercialized vaccines, and vaccines in clinical trials or in research. VIOLIN contains information for 454 vaccines or vaccine candidates for 73 pathogens. VIOLIN also contains many bioinformatics tools for vaccine data analysis, data integration, and vaccine target prediction. To demonstrate the applicability of VIOLIN for vaccine research, VIOLIN was used for bioinformatics analysis of existing Brucella vaccines and prediction of new Brucella vaccine targets. VIOLIN contains many literature mining programs (e.g., Vaxmesh) that provide in-depth analysis of Brucella vaccine literature. As a result of manual literature curation, VIOLIN contains information for 38 Brucella vaccines or vaccine candidates, 14 protective Brucella antigens, and 68 host response studies to Brucella vaccines from 97 peer-reviewed articles. These Brucella vaccines are classified in the Vaccine Ontology (VO) system and used for different ontological applications. The web-based VIOLIN vaccine target prediction program Vaxign was used to predict new Brucella vaccine targets. Vaxign identified 14 outer membrane proteins that are conserved in six virulent strains from B. abortus, B. melitensis, and B. suis that are pathogenic in humans. Of the 14 membrane proteins, two proteins (Omp2b and Omp31-1) are not present in B. ovis, a Brucella species that is not pathogenic in humans. Brucella vaccine data stored in VIOLIN were compared and analyzed using the VIOLIN query system. Bioinformatics curation and ontological representation of Brucella vaccines

  4. Longitudinal Meta-analysis

    NARCIS (Netherlands)

    Hox, J.J.; Maas, C.J.M.; Lensvelt-Mulders, G.J.L.M.

    2004-01-01

    The goal of meta-analysis is to integrate the research results of a number of studies on a specific topic. Characteristic for meta-analysis is that in general only the summary statistics of the studies are used and not the original data. When the published research results to be integrated

  5. Longitudinal analysis of serological tests officially adopted by the Brazilian Ministry of Health for the diagnosis of canine visceral leishmaniasis in dogs vaccinated with Leishmune®.

    Science.gov (United States)

    Marcondes, Mary; de Lima, Valéria Marçal Félix; de Araújo, Maria de Fátima Lereno; Hiramoto, Roberto Mitsuyoshi; Tolezano, José Eduardo; Vieira, Rafael F C; Biondo, Alexander W

    2013-11-08

    Development of vaccines against canine visceral leishmaniasis (CVL) may provide a prophylactic barrier, but antibody response detected by standard diagnostic techniques may not separate vaccinated from naturally infected dogs. Moreover, anti-Leishmania antibody levels in vaccinated dogs may be detectable for months. Accordingly, the aim of the present study was to comparatively evaluate an "in-house" ELISA with three serological tests officially adopted by the Brazilian Ministry of Health for the diagnosis of CVL in dogs vaccinated with Leishmune(®). A total of 18 mongrel dogs were submitted to a complete protocol of the vaccine, monitored and evaluated in 5 times (T0-T4) up to 180 days after T0. Twenty-one days after the first dose (T1), 50% of the dogs were seropositive by the "in-house" ELISA and 5.5% by IFAT, while by the official ELISA and DPP(®) CVL rapid test all dogs tested negative. At time T2, 42 days after of the first dose, 100%, 83.3%, 11.1%, and 5.5% of the dogs were seropositive by the "in-house" ELISA, IFAT, official ELISA kit and the DPP(®) CVL rapid test, respectively. Ninety days after the first dose (T3), 100%, 83.3%, 72.2% and 33.3% of the dogs were seropositive by the "in-house" ELISA, official ELISA kit, IFAT, and the DPP(®) CVL rapid test, respectively. Finally, at time T4, 88.8%, 33.3%, 11.1% and 5.5% of the dogs were seropositive by the "in-house" ELISA, official ELISA kit, DPP(®) CVL rapid test and IFAT, respectively. In conclusion, dogs vaccinated with Leishmune(®) cross-react by an "in-house" ELISA and by the three official Brazilian serological tests for the diagnosis of canine visceral leishmaniasis up to six months after the first vaccine dose, and may be mistakenly diagnosed and removed. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Teenage smoking: a longitudinal analysis.

    Science.gov (United States)

    Shahtahmasebi, Said; Berridge, Damon

    2005-01-01

    This paper examines the binary recurrent outcome "teenage smoking" within a statistical modelling paradigm. The proposed statistical modelling relates smoking to a set of explanatory variables, which include subjective as well as objective measures. In order to assess the degree to which explanatory variables influence smoking, an adequate statistical model must handle the possibility that substantial variation between respondents will be due to omitted variables, multicollinearity and past behaviour. An earlier paper, using a secondary cross-sectional data source, concluded that an investigation of smoking needs to be based on longitudinal data using appropriate statistical modelling. The same data source provided observations on young adults over a period of 2 years. For comparison purposes, the same cross-sectional model was fitted to the longitudinal data. The results suggest there may be substantial heterogeneity due to omitted variables in the data and complex inter-relationships between observed explanatory variables leading to underestimation. Longitudinal data provide additional flexibility to control for omitted variables and are necessary to investigate dynamic social processes such as smoking. The results from our analysis suggest that the effects of variables reported in the literature on teenage smoking may be overestimated. For example, the role of peer pressure may not be as clear as it has been made out to be.

  7. Human papillomavirus vaccination and sexual behaviour: cross-sectional and longitudinal surveys conducted in England.

    Science.gov (United States)

    Forster, Alice S; Marlow, Laura A V; Stephenson, Judith; Wardle, Jane; Waller, Jo

    2012-07-13

    To examine whether HPV vaccination influences sexual behaviour in adolescent girls, either by giving them a 'green light' to have sex, or because perceived protection afforded by the vaccine permits compensatory risky sexual behaviour. Cross-sectional and longitudinal surveys. Seven English schools. Self-reported sexual behaviour. The cross-sectional survey included 1053 girls (mean age 17.1 years) who had (n=433 recruited in March 2010) or had not (n=620 recruited in March 2009) been offered the HPV vaccine. The longitudinal survey included 407 girls (mean age 17.5 years) who had been offered HPV vaccination and had either received at least one dose (n=148) or had not received any doses (n=259). In the cross-sectional survey, the group of girls who had been offered the HPV vaccine were no more likely to be sexually active than the group of girls who had not been offered the HPV vaccine. In the longitudinal survey, the vaccinated group were no more likely to have changed their condom use or increased their total number of sexual partners than the unvaccinated group. Neither being offered the HPV vaccine nor receiving it affected sexual behaviour. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. LSTGEE: longitudinal analysis of neuroimaging data

    Science.gov (United States)

    Li, Yimei; Zhu, Hongtu; Chen, Yasheng; An, Hongyu; Gilmore, John; Lin, Weili; Shen, Dinggang

    2009-02-01

    Longitudinal imaging studies are essential to understanding the neural development of neuropsychiatric disorders, substance use disorders, and normal brain. Using appropriate image processing and statistical tools to analyze the imaging, behavioral, and clinical data is critical for optimally exploring and interpreting the findings from those imaging studies. However, the existing imaging processing and statistical methods for analyzing imaging longitudinal measures are primarily developed for cross-sectional neuroimaging studies. The simple use of these cross-sectional tools to longitudinal imaging studies will significantly decrease the statistical power of longitudinal studies in detecting subtle changes of imaging measures and the causal role of time-dependent covariate in disease process. The main objective of this paper is to develop longitudinal statistics toolbox, called LSTGEE, for the analysis of neuroimaging data from longitudinal studies. We develop generalized estimating equations for jointly modeling imaging measures with behavioral and clinical variables from longitudinal studies. We develop a test procedure based on a score test statistic and a resampling method to test linear hypotheses of unknown parameters, such as associations between brain structure and function and covariates of interest, such as IQ, age, gene, diagnostic groups, and severity of disease. We demonstrate the application of our statistical methods to the detection of the changes of the fractional anisotropy across time in a longitudinal neonate study. Particularly, our results demonstrate that the use of longitudinal statistics can dramatically increase the statistical power in detecting the changes of neuroimaging measures. The proposed approach can be applied to longitudinal data with multiple outcomes and accommodate incomplete and unbalanced data, i.e., subjects with different number of measurements.

  9. Longitudinal Association Analysis of Quantitative Traits

    Science.gov (United States)

    Fan, Ruzong; Zhang, Yiwei; Albert, Paul S.; Liu, Aiyi; Wang, Yuanjia; Xiong, Momiao

    2015-01-01

    Longitudinal genetic studies provide a valuable resource for exploring key genetic and environmental factors that affect complex traits over time. Genetic analysis of longitudinal data that incorporate temporal variations is important for understanding genetic architecture and biological variations of common complex diseases. Although they are important, there is a paucity of statistical methods to analyze longitudinal human genetic data. In this article, longitudinal methods are developed for temporal association mapping to analyze population longitudinal data. Both parametric and nonparametric models are proposed. The models can be applied to multiple diallelic genetic markers such as single-nucleotide polymorphisms and multiallelic markers such as microsatellites. By analytical formulae, we show that the models take both the linkage disequilibrium and temporal trends into account simultaneously. Variance-covariance structure is constructed to model the single measurement variation and multiple measurement correlations of an individual based on the theory of stochastic processes. Novel penalized spline models are used to estimate the time-dependent mean functions and regression coefficients. The methods were applied to analyze Framingham Heart Study data of Genetic Analysis Workshop (GAW) 13 and GAW 16. The temporal trends and genetic effects of the systolic blood pressure are successfully detected by the proposed approaches. Simulation studies were performed to find out that the nonparametric penalized linear model is the best choice in fitting real data. The research sheds light on the important area of longitudinal genetic analysis, and it provides a basis for future methodological investigations and practical applications. PMID:22965819

  10. A Longitudinal Randomized Trial of the Effect of Consistent Pain Management for Infant Vaccinations on Future Vaccination Distress.

    Science.gov (United States)

    Taddio, Anna; Riddell, Rebecca Pillai; Ipp, Moshe; Moss, Steven; Baker, Stephen; Tolkin, Jonathan; Dave, Malini; Feerasta, Sharmeen; Govan, Preeya; Fletcher, Emma; Wong, Horace; McNair, Caitlin; Mithal, Priyanjali; Stephens, Derek

    2017-09-01

    The objective was to determine if consistent pain management during vaccine injections has a beneficial effect on future infant pain reactivity. This was a multicenter, longitudinal, double-blind, double-dummy, add-on, randomized controlled trial. Healthy infants were randomized to 1 of 4 add-on pain management regimens for all vaccinations in the first year of life: 1) placebo control (standard care), 2) parent video education about infant soothing (video), 3) video and oral sucrose solution (sucrose), 4) video and sucrose and topical liposomal lidocaine (lidocaine). At 15-month vaccinations, all active pain interventions were administered (video and sucrose and lidocaine); however, individuals remained blinded to the original treatments given. Pain at 15 months was evaluated during 3 procedure phases (baseline, needle injection, and recovery) by a researcher unaware of group allocation using a validated measure, the Modified Behavioural Pain Scale (range, 0-10). Altogether, 352 infants participated; characteristics did not differ among groups (P > .05). Pain scores did not differ among groups during baseline (P = .642), needle injection (P = .739), or recovery (P = .750) phases. In conclusion, there was no evidence of a long-term benefit of consistent use of pain interventions in the first year of life on future infant pain responsivity at 15-month vaccinations. This randomized controlled trial did not find a long-term benefit of consistent pain management during infant vaccinations on future infant pain responsivity at 15 months. The results are relevant to clinicians and researchers studying and evaluating pain interventions in children undergoing medical procedures. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Motivational and contextual determinants of HPV-vaccination uptake: A longitudinal study among mothers of girls invited for the HPV-vaccination.

    Science.gov (United States)

    Pot, Mirjam; van Keulen, Hilde M; Ruiter, Robert A C; Eekhout, Iris; Mollema, Liesbeth; Paulussen, Theo W G M

    2017-07-01

    In the Netherlands, HPV-vaccination uptake among 12-year-old girls remains to be lower (61% in 2016) than expected. The present study is about 1) replicating the extent to which social-psychological determinants found in earlier cross-sectional studies explain HPV-vaccination intention, and 2) testing whether HPV-vaccination intention, as well as other social-psychological determinants, are good predictors of future HPV-vaccination uptake in a longitudinal design. A random sample of mothers of girls invited for the vaccination in 2015 was drawn from the Dutch vaccination register (Praeventis) (N=36,000) and from three online panels (N=2483). Two months prior to the vaccination of girls, their mothers were requested to complete a web-based questionnaire by letter (Praeventis sample) or by e-mail (panel samples). HPV-vaccination uptake was derived from Praeventis. Backward linear and logistic regression analyses were conducted to examine most dominant predictors of HPV-vaccination intention and uptake, respectively. The total sample used for data analyses consisted of 8062 mothers. Response rates were 18% for the Praeventis sample and 47% for the panel samples. HPV-vaccination intention was best explained by attitude, beliefs, subjective norms, habit, and perceived relative effectiveness of the vaccination; they explained 83% of the variance in HPV-vaccination intention. Intention appeared to be the only stable predictor of HPV-vaccination uptake and explained 43% of the variance in HPV-vaccination uptake. These results confirm what was found by earlier cross-sectional studies, and provide strong leads for selecting relevant targets in the planning of future communication strategies aiming to improve HPV-vaccination uptake. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Vaccines for human papillomavirus infection: a critical analysis.

    Science.gov (United States)

    Nath, Amiya Kumar; Thappa, Devinder Mohan

    2009-01-01

    This article takes a critical look at the pros and cons of human papillomavirus (HPV) vaccines. There is enough evidence to suggest that the prophylactic vaccines are efficacious in preventing various benign and malignant conditions (including cervical cancers) caused by HPV. Even though the vaccine is costly, hypothetical analysis has shown that HPV vaccination will be cost effective in the long run. Therapeutic HPV vaccines used to treat established disease are still undergoing evaluation in clinical studies, and results seem to be encouraging. Although several countries have started mandatory vaccination programs with the prophylactic HPV vaccines, conservatives have voiced concerns regarding the moral impact of such vaccination programs.

  13. Vaccination coverage among children in Germany estimated by analysis of health insurance claims data

    Science.gov (United States)

    Rieck, Thorsten; Feig, Marcel; Eckmanns, Tim; Benzler, Justus; Siedler, Anette; Wichmann, Ole

    2014-01-01

    In Germany, the national routine childhood immunization schedule comprises 12 vaccinations. Primary immunizations should be completed by 24 mo of age. However, nationwide monitoring of vaccination coverage (VC) is performed only at school entry. We utilized health insurance claims data covering ~85% of the total population with the objectives to (1) assess VC of all recommended childhood vaccinations in birth-cohorts 2004–2009, (2) analyze cross-sectional (at 24 and 36 mo) and longitudinal trends, and (3) validate the method internally and externally. Counting vaccine doses in a retrospective cohort fashion, we assembled individual vaccination histories and summarized VC to nationwide figures. For most long-established vaccinations, VC at 24 mo was at moderate levels (~73–80%) and increased slightly across birth-cohorts. One dose measles VC was high (94%), but low (69%) for the second dose. VC with a full course of recently introduced varicella, pneumococcal, and meningococcal C vaccines increased across birth-cohorts from below 10% above 60%, 70%, and 80%, respectively. At 36 mo, VC had increased further by up to 15 percentage points depending on vaccination. Longitudinal analysis suggested a continued VC increase until school entry. Validation of VC figures with primary data showed an overall good agreement. In conclusion, analysis of health insurance claims data allows for the estimation of VC among children in Germany considering completeness and timeliness of vaccination series. This approach provides valid nationwide VC figures for all currently recommended pediatric vaccinations and fills the information gap between early infancy and late assessment at school entry. PMID:24192604

  14. A comparative analysis of influenza vaccination programs.

    Directory of Open Access Journals (Sweden)

    Shweta Bansal

    2006-10-01

    Full Text Available BACKGROUND: The threat of avian influenza and the 2004-2005 influenza vaccine supply shortage in the United States have sparked a debate about optimal vaccination strategies to reduce the burden of morbidity and mortality caused by the influenza virus. METHODS AND FINDINGS: We present a comparative analysis of two classes of suggested vaccination strategies: mortality-based strategies that target high-risk populations and morbidity-based strategies that target high-prevalence populations. Applying the methods of contact network epidemiology to a model of disease transmission in a large urban population, we assume that vaccine supplies are limited and then evaluate the efficacy of these strategies across a wide range of viral transmission rates and for two different age-specific mortality distributions. We find that the optimal strategy depends critically on the viral transmission level (reproductive rate of the virus: morbidity-based strategies outperform mortality-based strategies for moderately transmissible strains, while the reverse is true for highly transmissible strains. These results hold for a range of mortality rates reported for prior influenza epidemics and pandemics. Furthermore, we show that vaccination delays and multiple introductions of disease into the community have a more detrimental impact on morbidity-based strategies than mortality-based strategies. CONCLUSIONS: If public health officials have reasonable estimates of the viral transmission rate and the frequency of new introductions into the community prior to an outbreak, then these methods can guide the design of optimal vaccination priorities. When such information is unreliable or not available, as is often the case, this study recommends mortality-based vaccination priorities.

  15. The Digital Distribution of Public Health News Surrounding the Human Papillomavirus Vaccination: A Longitudinal Infodemiology Study.

    Science.gov (United States)

    Mahoney, L Meghan; Tang, Tang; Ji, Kai; Ulrich-Schad, Jessica

    2015-01-01

    New media changes the dissemination of public health information and misinformation. During a guest appearance on the Today Show, US Representative Michele Bachmann claimed that human papillomavirus (HPV) vaccines could cause "mental retardation". The purpose of this study is to explore how new media influences the type of public health information users access, as well as the impact to these platforms after a major controversy. Specifically, this study aims to examine the similarities and differences in the dissemination of news articles related to the HPV vaccination between Google News and Twitter, as well as how the content of news changed after Michele Bachmann's controversial comment. This study used a purposive sampling to draw the first 100 news articles that appeared on Google News and the first 100 articles that appeared on Twitter from August 1-October 31, 2011. Article tone, source, topics, concerns, references, publication date, and interactive features were coded. The intercoder reliability had a total agreement of .90. Results indicate that 44.0% of the articles (88/200) about the HPV vaccination had a positive tone, 32.5% (65/200) maintained a neutral tone, while 23.5% (47/200) presented a negative tone. Protection against diseases 82.0% (164/200), vaccine eligibility for females 75.5% (151/200), and side effects 59.0% (118/200) were the top three topics covered by these articles. Google News and Twitter articles significantly differed in article tone, source, topics, concerns covered, types of sources referenced in the article, and uses of interactive features. Most notably, topic focus changed from public health information towards political conversation after Bachmann's comment. Before the comment, the HPV vaccine news talked more often about vaccine dosing (Ptopic shifted towards politics (P=.01) and talked more about HPV vaccine eligibility for males (P=.01). This longitudinal infodemiology study suggests that new media influences public health

  16. Longitudinal analysis strategies for modelling epigenetic trajectories.

    Science.gov (United States)

    Staley, James R; Suderman, Matthew; Simpkin, Andrew J; Gaunt, Tom R; Heron, Jon; Relton, Caroline L; Tilling, Kate

    2018-02-16

    DNA methylation levels are known to vary over time, and modelling these trajectories is crucial for our understanding of the biological relevance of these changes over time. However, due to the computational cost of fitting multilevel models across the epigenome, most trajectory modelling efforts to date have focused on a subset of CpG sites identified through epigenome-wide association studies (EWAS) at individual time-points. We propose using linear regression across the repeated measures, estimating cluster-robust standard errors using a sandwich estimator, as a less computationally intensive strategy than multilevel modelling. We compared these two longitudinal approaches, as well as three approaches based on EWAS (associated at baseline, at any time-point and at all time-points), for identifying epigenetic change over time related to an exposure using simulations and by applying them to blood DNA methylation profiles from the Accessible Resource for Integrated Epigenomics Studies (ARIES). Restricting association testing to EWAS at baseline identified a less complete set of associations than performing EWAS at each time-point or applying the longitudinal modelling approaches to the full dataset. Linear regression models with cluster-robust standard errors identified similar sets of associations with almost identical estimates of effect as the multilevel models, while also being 74 times more efficient. Both longitudinal modelling approaches identified comparable sets of CpG sites in ARIES with an association with prenatal exposure to smoking (>70% agreement). Linear regression with cluster-robust standard errors is an appropriate and efficient approach for longitudinal analysis of DNA methylation data.

  17. Event time analysis of longitudinal neuroimage data.

    Science.gov (United States)

    Sabuncu, Mert R; Bernal-Rusiel, Jorge L; Reuter, Martin; Greve, Douglas N; Fischl, Bruce

    2014-08-15

    This paper presents a method for the statistical analysis of the associations between longitudinal neuroimaging measurements, e.g., of cortical thickness, and the timing of a clinical event of interest, e.g., disease onset. The proposed approach consists of two steps, the first of which employs a linear mixed effects (LME) model to capture temporal variation in serial imaging data. The second step utilizes the extended Cox regression model to examine the relationship between time-dependent imaging measurements and the timing of the event of interest. We demonstrate the proposed method both for the univariate analysis of image-derived biomarkers, e.g., the volume of a structure of interest, and the exploratory mass-univariate analysis of measurements contained in maps, such as cortical thickness and gray matter density. The mass-univariate method employs a recently developed spatial extension of the LME model. We applied our method to analyze structural measurements computed using FreeSurfer, a widely used brain Magnetic Resonance Image (MRI) analysis software package. We provide a quantitative and objective empirical evaluation of the statistical performance of the proposed method on longitudinal data from subjects suffering from Mild Cognitive Impairment (MCI) at baseline. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Post-neonatal Mortality Impacts Following Grants from the Gavi Vaccine Alliance: An Econometric Analysis from 2000 to 2014

    OpenAIRE

    KOLESAR, Robert John; Audibert, Martine

    2017-01-01

    We completed a retrospective multivariate panel and longitudinal trend study to evaluate the effect of Gavi Vaccine Alliance grants on vaccine-preventable disease (VPD) post-neonatal mortality. Feasible Generalized Least Squares (fGLS) regression analysis was used to examine the association between VPD post-neonatal mortality rates and Gavi funding. We also applied segmented regression analysis to assess the structural trend in VPD post-neonatal mortality rates, the impact of Gavi funding, an...

  19. Semantic network analysis of vaccine sentiment in online social media.

    Science.gov (United States)

    Kang, Gloria J; Ewing-Nelson, Sinclair R; Mackey, Lauren; Schlitt, James T; Marathe, Achla; Abbas, Kaja M; Swarup, Samarth

    2017-06-22

    To examine current vaccine sentiment on social media by constructing and analyzing semantic networks of vaccine information from highly shared websites of Twitter users in the United States; and to assist public health communication of vaccines. Vaccine hesitancy continues to contribute to suboptimal vaccination coverage in the United States, posing significant risk of disease outbreaks, yet remains poorly understood. We constructed semantic networks of vaccine information from internet articles shared by Twitter users in the United States. We analyzed resulting network topology, compared semantic differences, and identified the most salient concepts within networks expressing positive, negative, and neutral vaccine sentiment. The semantic network of positive vaccine sentiment demonstrated greater cohesiveness in discourse compared to the larger, less-connected network of negative vaccine sentiment. The positive sentiment network centered around parents and focused on communicating health risks and benefits, highlighting medical concepts such as measles, autism, HPV vaccine, vaccine-autism link, meningococcal disease, and MMR vaccine. In contrast, the negative network centered around children and focused on organizational bodies such as CDC, vaccine industry, doctors, mainstream media, pharmaceutical companies, and United States. The prevalence of negative vaccine sentiment was demonstrated through diverse messaging, framed around skepticism and distrust of government organizations that communicate scientific evidence supporting positive vaccine benefits. Semantic network analysis of vaccine sentiment in online social media can enhance understanding of the scope and variability of current attitudes and beliefs toward vaccines. Our study synthesizes quantitative and qualitative evidence from an interdisciplinary approach to better understand complex drivers of vaccine hesitancy for public health communication, to improve vaccine confidence and vaccination coverage

  20. Potential Use of Salivary Markers for Longitudinal Monitoring of Inflammatory Immune Responses to Vaccination

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    Pei Wen Lim

    2016-01-01

    Full Text Available Vaccination, designed to trigger a protective immune response against infection, is a trigger for mild inflammatory responses. Vaccination studies can address the question of inflammation initiation, levels, and resolution as well as its regulation for respective studied pathogens. Such studies largely based on analyzing the blood components including specific antibodies and cytokines were usually constrained by number of participants and volume of collected blood sample. Hence, blood-based studies may not be able to cover the full dynamic range of inflammation responses induced by vaccination. In this review, the potential of using saliva in addition to blood for studying the kinetics of inflammatory response studies was assessed. Saliva sampling is noninvasive and has a great potential to be used for studies aimed at analysing the magnitude, time course, and variance in immune responses, including inflammation after vaccination. Based on a literature survey of inflammatory biomarkers that can be determined in saliva and an analysis of how these biomarkers could help to understand the mechanisms and dynamics of immune reactivity and inflammation, we propose that the saliva-based approach might have potential to add substantial value to clinical studies, particularly in vulnerable populations such as infants, toddlers, and ill individuals.

  1. Vaxjo: A Web-Based Vaccine Adjuvant Database and Its Application for Analysis of Vaccine Adjuvants and Their Uses in Vaccine Development

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    Samantha Sayers

    2012-01-01

    Full Text Available Vaccine adjuvants are compounds that enhance host immune responses to co-administered antigens in vaccines. Vaxjo is a web-based central database and analysis system that curates, stores, and analyzes vaccine adjuvants and their usages in vaccine development. Basic information of a vaccine adjuvant stored in Vaxjo includes adjuvant name, components, structure, appearance, storage, preparation, function, safety, and vaccines that use this adjuvant. Reliable references are curated and cited. Bioinformatics scripts are developed and used to link vaccine adjuvants to different adjuvanted vaccines stored in the general VIOLIN vaccine database. Presently, 103 vaccine adjuvants have been curated in Vaxjo. Among these adjuvants, 98 have been used in 384 vaccines stored in VIOLIN against over 81 pathogens, cancers, or allergies. All these vaccine adjuvants are categorized and analyzed based on adjuvant types, pathogens used, and vaccine types. As a use case study of vaccine adjuvants in infectious disease vaccines, the adjuvants used in Brucella vaccines are specifically analyzed. A user-friendly web query and visualization interface is developed for interactive vaccine adjuvant search. To support data exchange, the information of vaccine adjuvants is stored in the Vaccine Ontology (VO in the Web Ontology Language (OWL format.

  2. Longitudinal data analysis a handbook of modern statistical methods

    CERN Document Server

    Fitzmaurice, Garrett; Verbeke, Geert; Molenberghs, Geert

    2008-01-01

    Although many books currently available describe statistical models and methods for analyzing longitudinal data, they do not highlight connections between various research threads in the statistical literature. Responding to this void, Longitudinal Data Analysis provides a clear, comprehensive, and unified overview of state-of-the-art theory and applications. It also focuses on the assorted challenges that arise in analyzing longitudinal data. After discussing historical aspects, leading researchers explore four broad themes: parametric modeling, nonparametric and semiparametric methods, joint

  3. An analysis of the pediatric vaccine supply shortage problem.

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    Jacobson, Sheldon H; Sewell, Edward C; Proano, Ruben A

    2006-11-01

    In 2002, several factors resulted in pediatric vaccine manufacturers not being able to produce a sufficient number of vaccines to vaccinate all the children in the United States according to the Recommended Childhood Immunization Schedule. The resulting vaccine supply shortage resulted in thousands of children not being fully immunized according to this schedule, and hence, created an unnecessary risk for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention responded to this crisis by using pediatric vaccine stockpiles to mitigate the impact of future shortages. This paper presents a stochastic model that captures the vaccine supply during production interruptions. This model is used to assess the impact of pediatric vaccine stockpile levels on vaccination coverage rates, by considering the probability that all children can be immunized according to the Recommended Childhood Immunization Schedule over a given time period and the expected minimum vaccine supply. The model is also used to assess the proposed pediatric vaccine stockpile levels recommended by the United States Department of Health and Human Services. The results of this analysis suggest that the proposed vaccine stockpile levels are adequate to meet future vaccine production interruptions, provided that such production interruptions do not last more than six months (which is not surprising, given that is the time period for which they were designed). However, given that recent vaccine production interruptions have lasted (on average) for over one year, the proposed vaccine stockpile levels are insufficient to meet the nation's pediatric immunization needs during such time periods, which in turn could lead to localized and/or widespread disease outbreaks. Moreover, a moderate investment in higher vaccine stockpile levels would lead to a significantly reduced risk of such events.

  4. Longitudinal analysis of HIV risk behaviour patterns and their ...

    African Journals Online (AJOL)

    2018-02-06

    Feb 6, 2018 ... To cite this article: Karl Peltzer (2018) Longitudinal analysis of HIV risk behaviour patterns and their predictors among public .... Methods. Study design. This is a longitudinal observational study of TB patients with hazardous or harmful drinking problems in public primary care clinics in South Africa. Sample ...

  5. Time-Course Gene Set Analysis for Longitudinal Gene Expression Data.

    Directory of Open Access Journals (Sweden)

    Boris P Hejblum

    2015-06-01

    Full Text Available Gene set analysis methods, which consider predefined groups of genes in the analysis of genomic data, have been successfully applied for analyzing gene expression data in cross-sectional studies. The time-course gene set analysis (TcGSA introduced here is an extension of gene set analysis to longitudinal data. The proposed method relies on random effects modeling with maximum likelihood estimates. It allows to use all available repeated measurements while dealing with unbalanced data due to missing at random (MAR measurements. TcGSA is a hypothesis driven method that identifies a priori defined gene sets with significant expression variations over time, taking into account the potential heterogeneity of expression within gene sets. When biological conditions are compared, the method indicates if the time patterns of gene sets significantly differ according to these conditions. The interest of the method is illustrated by its application to two real life datasets: an HIV therapeutic vaccine trial (DALIA-1 trial, and data from a recent study on influenza and pneumococcal vaccines. In the DALIA-1 trial TcGSA revealed a significant change in gene expression over time within 69 gene sets during vaccination, while a standard univariate individual gene analysis corrected for multiple testing as well as a standard a Gene Set Enrichment Analysis (GSEA for time series both failed to detect any significant pattern change over time. When applied to the second illustrative data set, TcGSA allowed the identification of 4 gene sets finally found to be linked with the influenza vaccine too although they were found to be associated to the pneumococcal vaccine only in previous analyses. In our simulation study TcGSA exhibits good statistical properties, and an increased power compared to other approaches for analyzing time-course expression patterns of gene sets. The method is made available for the community through an R package.

  6. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network

    Science.gov (United States)

    2011-01-01

    identified. The asserted and inferred VO hierarchies provide semantic support for inferring novel knowledge of association of vaccines and genes from the retrieved data. New hypotheses were generated based on this analysis approach. Conclusion VO-SciMiner can be used to improve the efficiency for PubMed searching in the vaccine domain. PMID:21871085

  7. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network.

    Science.gov (United States)

    Hur, Junguk; Xiang, Zuoshuang; Feldman, Eva L; He, Yongqun

    2011-08-26

    and inferred VO hierarchies provide semantic support for inferring novel knowledge of association of vaccines and genes from the retrieved data. New hypotheses were generated based on this analysis approach. VO-SciMiner can be used to improve the efficiency for PubMed searching in the vaccine domain.

  8. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network

    Directory of Open Access Journals (Sweden)

    Xiang Zuoshuang

    2011-08-01

    vaccines and genes were identified. The asserted and inferred VO hierarchies provide semantic support for inferring novel knowledge of association of vaccines and genes from the retrieved data. New hypotheses were generated based on this analysis approach. Conclusion VO-SciMiner can be used to improve the efficiency for PubMed searching in the vaccine domain.

  9. Analysis of novel meningococcal vaccine formulations.

    Science.gov (United States)

    Zughaier, Susu M

    2017-07-03

    The protective effect of meningococcal vaccines targeting disease causing serogroups exemplified by the introduction of MenAfriVac™ in Africa, is well established and documented in large population-based studies. Due to the emergence of other meningococcal disease causing serogroups, novel vaccine formulations are needed. There is a high potential for novel nanotechnology-based meningococcal vaccine formulations that can provide wider vaccine coverage. The proposed meningococcal vaccine formulation contains spherical shaped micro and nanoparticles that are biological mimics of Niesseria meningitidis, therefore present to immune system as invader and elicit robust immune responses. Vaccine nanoparticles encapsulate meningococcal CPS polymers in a biodegradable material that slowly release antigens, therefore enhance antigen presentation by exerting antigen depot effect. The antigenicity of meningococcal vaccine delivered in nanoparticles is significantly higher when compared to vaccine delivered in solution. Preclinical studies are required to assess the immunogenicity of novel vaccine formulations. Therefore, implementing various in-vitro human immune cell-based assays that mimic in-vivo interactions, would provide good insight on optimal antigen dose, effective antigen presentation, facilitate screening of various vaccine and adjuvant combinations and predict in-vivo immunogenicity. This rapid approach is cost-effective and provides data required for the preclinical immunogenicity assessment of novel meningococcal vaccine formulations.

  10. The Role of Microsimulation in Longitudinal Data Analysis

    Directory of Open Access Journals (Sweden)

    Douglas A. Wolf

    2001-12-01

    microsimulation also has the potential to contribute to longitudinal data analysis in several ways, including extending the range of outputs generated by a model, addressing several defective-data problems, and serving as a vehicle for missing-data imputation. This paper discusses microsimulation procedures suitable for several commonly-used statistical models applied to longitudinal data. It also addresses the unique role that can be played by microsimulation in longitudinal data analysis, and the problem of accounting for the several sources of variability associated with microsimulation procedures.

  11. Meta-analysis of variables affecting mouse protection efficacy of whole organism Brucella vaccines and vaccine candidates.

    Science.gov (United States)

    Todd, Thomas E; Tibi, Omar; Lin, Yu; Sayers, Samantha; Bronner, Denise N; Xiang, Zuoshuang; He, Yongqun

    2013-01-01

    Vaccine protection investigation includes three processes: vaccination, pathogen challenge, and vaccine protection efficacy assessment. Many variables can affect the results of vaccine protection. Brucella, a genus of facultative intracellular bacteria, is the etiologic agent of brucellosis in humans and multiple animal species. Extensive research has been conducted in developing effective live attenuated Brucella vaccines. We hypothesized that some variables play a more important role than others in determining vaccine protective efficacy. Using Brucella vaccines and vaccine candidates as study models, this hypothesis was tested by meta-analysis of Brucella vaccine studies reported in the literature. Nineteen variables related to vaccine-induced protection of mice against infection with virulent brucellae were selected based on modeling investigation of the vaccine protection processes. The variable "vaccine protection efficacy" was set as a dependent variable while the other eighteen were set as independent variables. Discrete or continuous values were collected from papers for each variable of each data set. In total, 401 experimental groups were manually annotated from 74 peer-reviewed publications containing mouse protection data for live attenuated Brucella vaccines or vaccine candidates. Our ANOVA analysis indicated that nine variables contributed significantly (P-value Brucella vaccine protection efficacy: vaccine strain, vaccination host (mouse) strain, vaccination dose, vaccination route, challenge pathogen strain, challenge route, challenge-killing interval, colony forming units (CFUs) in mouse spleen, and CFU reduction compared to control group. The other 10 variables (e.g., mouse age, vaccination-challenge interval, and challenge dose) were not found to be statistically significant (P-value > 0.05). The protection level of RB51 was sacrificed when the values of several variables (e.g., vaccination route, vaccine viability, and challenge pathogen strain

  12. Meta-analysis of variables affecting mouse protection efficacy of whole organism Brucella vaccines and vaccine candidates

    Science.gov (United States)

    2013-01-01

    Background Vaccine protection investigation includes three processes: vaccination, pathogen challenge, and vaccine protection efficacy assessment. Many variables can affect the results of vaccine protection. Brucella, a genus of facultative intracellular bacteria, is the etiologic agent of brucellosis in humans and multiple animal species. Extensive research has been conducted in developing effective live attenuated Brucella vaccines. We hypothesized that some variables play a more important role than others in determining vaccine protective efficacy. Using Brucella vaccines and vaccine candidates as study models, this hypothesis was tested by meta-analysis of Brucella vaccine studies reported in the literature. Results Nineteen variables related to vaccine-induced protection of mice against infection with virulent brucellae were selected based on modeling investigation of the vaccine protection processes. The variable "vaccine protection efficacy" was set as a dependent variable while the other eighteen were set as independent variables. Discrete or continuous values were collected from papers for each variable of each data set. In total, 401 experimental groups were manually annotated from 74 peer-reviewed publications containing mouse protection data for live attenuated Brucella vaccines or vaccine candidates. Our ANOVA analysis indicated that nine variables contributed significantly (P-value Brucella vaccine protection efficacy: vaccine strain, vaccination host (mouse) strain, vaccination dose, vaccination route, challenge pathogen strain, challenge route, challenge-killing interval, colony forming units (CFUs) in mouse spleen, and CFU reduction compared to control group. The other 10 variables (e.g., mouse age, vaccination-challenge interval, and challenge dose) were not found to be statistically significant (P-value > 0.05). The protection level of RB51 was sacrificed when the values of several variables (e.g., vaccination route, vaccine viability, and

  13. Cattle rabies vaccination--A longitudinal study of rabies antibody titres in an Israeli dairy herd.

    Science.gov (United States)

    Yakobson, Boris; Taylor, Nick; Dveres, Nelli; Rozenblut, Shira; Tov, Boris Even; Markos, Majid; Gallon, Nadav; Homer, David; Maki, Joanne

    2015-09-01

    In contrast to many regions of the world where rabies is endemic in terrestrial wildlife species, wildlife rabies has been controlled in Israel by oral rabies vaccination programs, but canine rabies is re-emerging in the northern area of the Golan Heights. From 2009 to 2014 there were 208 animal rabies cases in Israel; 96 (46%) were considered introduced primary cases in dogs, triggering 112 secondary cases. One third (37/112) of the secondary cases were in cattle. Rabies vaccination is voluntary for cattle in Israel, except those on public exhibit. Rabies vaccination schedules for cattle vary based on farm practices and perception of risk. In this study 59 cattle from a dairy farm which routinely vaccinates against rabies were assigned into six groups according to age and vaccination histories. Four groups contained adult cows which had received one previous rabies vaccination, one group of adults had received two previous vaccinations, and one group was unvaccinated calves. Serum samples were collected and the cows were vaccinated with a commercial rabies vaccine. Sera were again collected 39 days later and the calf group re-vaccinated and re-sampled 18 days later. Sera were analyzed for the presence of rabies virus neutralizing antibodies using the rapid immunofluorescent antibody test. Cattle with antibody titres ≥ 0.5 IU/ml were considered to be protected against rabies. Twenty-six of 27 adult cattle (96%) vaccinated once at less than five months old did not have protective titres. Sixty percent (6/10) cattle vaccinated once at around six months of age did have adequate titres. Cattle previously vaccinated twice (n=10; 100%) with an 18 month interval between inoculations, had protective titres and protective antibody titres following booster vaccination (n=51; 100%). The anamnestic response of cattle to a killed rabies vaccine was not affected by the time interval between vaccinations, which ranged from 12 to 36 months. These results suggest that calves from

  14. Longitudinal analysis of attitudes toward wolves.

    Science.gov (United States)

    Treves, Adrian; Naughton-Treves, Lisa; Shelley, Victoria

    2013-04-01

    Understanding individual attitudes and how these predict overt opposition to predator conservation or direct, covert action against predators will help to recover and maintain them. Studies of attitudes toward wild animals rely primarily on samples of individuals at a single time point. We examined longitudinal change in individuals' attitudes toward gray wolves (Canis lupus). In the contiguous United States, amidst persistent controversy and opposition, abundances of gray wolves are at their highest in 60 years. We used mailed surveys to sample 1892 residents of Wisconsin in 2001 or 2004 and then resampled 656 of these individuals who resided in wolf range in 2009. Our study spanned a period of policy shifts and increasing wolf abundance. Over time, the 656 respondents increased agreement with statements reflecting fear of wolves, the belief that wolves compete with hunters for deer (Odocoileus virginianus), and inclination to poach a wolf. Endorsement of lethal control of wolves by the state and public hunting of wolves also increased. Neither the time span over which respondents reported exposure to wolves locally nor self-reported losses of domestic animals to wolves correlated with changes in attitude. We predict future increases in legal and illegal killing of wolves that may reduce their abundance in Wisconsin unless interventions are implemented to improve attitudes and behavior toward wolves. To assess whether interventions change attitudes, longitudinal studies like ours are needed. Análisis Longitudinal de las Actitudes Hacia Lobos. © 2013 Society for Conservation Biology.

  15. Canonical Variate Analysis and Related Methods with Longitudinal Data

    OpenAIRE

    Beaghen, Michael Jr.

    1997-01-01

    Canonical variate analysis (CVA) is a widely used method for analyzing group structure in multivariate data. It is mathematically equivalent to a one-way multivariate analysis of variance and often goes by the name of canonical discriminant analysis. Change over time is a central feature of many phenomena of interest to researchers. This dissertation extends CVA to longitudinal data. It develops models whose purpose is to determi...

  16. ECONOMICAL ANALYSIS OF FLU VACCINE PREVENTION FOR CHILDREN AND TEENAGERS

    Directory of Open Access Journals (Sweden)

    D.Yu. Belousov

    2007-01-01

    Full Text Available This clinicalaeconomical analysis includes all possible treatament expenditures and possible profit from vaccinating chiladren and teenagers versus flue. It shoes that mass vaccination of children and teenagers will lead to lower disease incidence and mortality during epidemical rising of the disease and proavide significant economical effect both because of direct medaical expenses and because of collateral expenses. Collateral expenses are the main source of loss for the state of Russia from child and teenager flue and sars. Vaccination brings sick leaves and lost time payments down by 57%, expenses for treataing flue and sars together with their complications by 52%. In the Russian society total child and teenager vaccination appears as more profitable, for insurance companies as well. in this case insurance companies will be able to benefit from indirect medaical profit and, most probably, won't be needing state subsidizing for conducting total vaccination against flue of all citizens aged under 14. Antiaflue vaccination is feasible both in terms of clinical results and economic feasibility.Key words: pharmaeconomics, flue, sars, children, teenagers, vaccine prevention.

  17. Increased risk for an atypical autism diagnosis following Thimerosal-containing vaccine exposure in the United States: A prospective longitudinal case-control study in the Vaccine Safety Datalink.

    Science.gov (United States)

    Geier, David A; Kern, Janet K; Geier, Mark R

    2017-07-01

    Thimerosal is an organic-mercury (Hg)-containing compound (49.55% Hg by weight) historically added to many multi-dose vials of vaccine as a preservative and still added to some vaccines today. Concerns about the toxic effects from Thimerosal-containing childhood vaccines and the risk of an atypical autism diagnosis were evaluated in this study. A hypothesis-testing, prospective longitudinal, case-control study assessed exposure to Hg from Thimerosal-containing hepatitis B vaccines (TM-HepB) among cases diagnosed with atypical autism (n=164) and controls (n=15,216). Automated medical records for subjects born from 1991 to 2000 and continuously enrolled in the Vaccine Safety Datalink (VSD) database were examined. Cases diagnosed with atypical autism were statistically significantly more likely to have received greater overall and dose-dependent exposures to Hg from TM-HepB vaccines administered within the first month of life, first two months of life, and first six months of life than the controls. Similar phenomena were observed when cases and controls were separated by gender. Routine childhood vaccination is an important public health tool to reduce infectious diseases. The present study provides important epidemiological evidence significantly associating increasing Hg exposure from Thimerosal-containing childhood vaccines and the subsequent risk of atypical autism diagnosis, and suggests that Thimerosal should be eliminated from vaccines. Copyright © 2017 Elsevier GmbH. All rights reserved.

  18. Sensitivity Analysis of Mixed Models for Incomplete Longitudinal Data

    Science.gov (United States)

    Xu, Shu; Blozis, Shelley A.

    2011-01-01

    Mixed models are used for the analysis of data measured over time to study population-level change and individual differences in change characteristics. Linear and nonlinear functions may be used to describe a longitudinal response, individuals need not be observed at the same time points, and missing data, assumed to be missing at random (MAR),…

  19. Longitudinal Jitter Analysis of a Linear Accelerator Electron Gun

    Directory of Open Access Journals (Sweden)

    MingShan Liu

    2016-11-01

    Full Text Available We present measurements and analysis of the longitudinal timing jitter of a Beijing Electron Positron Collider (BEPCII linear accelerator electron gun. We simulated the longitudinal jitter effect of the gun using PARMELA to evaluate beam performance, including: beam profile, average energy, energy spread, and XY emittances. The maximum percentage difference of the beam parameters is calculated to be 100%, 13.27%, 42.24% and 65.01%, 86.81%, respectively. Due to this, the bunching efficiency is reduced to 54%. However, the longitudinal phase difference of the reference particle was 9.89°. The simulation results are in agreement with tests and are helpful to optimize the beam parameters by tuning the trigger timing of the gun during the bunching process.

  20. Communication about vaccinations in Italian websites: a quantitative analysis.

    Science.gov (United States)

    Tafuri, Silvio; Gallone, Maria S; Gallone, Maria F; Zorico, Ivan; Aiello, Valeria; Germinario, Cinzia

    2014-01-01

    Babies' parents and people who look for information about vaccination often visit anti-vaccine movement's websites, blogs by naturopathic physicians or natural and alternative medicine practitioners. The aim of this work is to provide a quantitative analysis on the type of information available to Italian people regarding vaccination and a quality analysis of websites retrieved through our searches. A quality score was created to evaluate the technical level of websites. A research was performed through Yahoo, Google, and MSN using the keywords "vaccine" and "vaccination," with the function "OR" in order to identify the most frequently used websites. The 2 keywords were input in Italian, and the first 15 pages retrieved by each search engine were analyzed. 149 websites were selected through this methodology. Fifty-three per cent of the websites belonged to associations, groups, or scientific companies, 32.2% (n = 48) consisted of a personal blog and 14.8% (n = 22) belonged to some of the National Health System offices. Among all analyzed websites, 15.4% (n = 23) came from anti-vaccine movement groups. 37.6% reported webmaster name, 67.8% webmaster e-mail, 28.6% indicated the date of the last update and 46.6% the author's name. The quality score for government sites was higher on average than anti-vaccine websites; although, government sites don't use Web 2.0 functions, as the forums.: National Health System institutions who have to promote vaccination cannot avoid investing in web communication because it cannot be managed by private efforts but must be the result of Public Health, private and scientific association, and social movement synergy.

  1. A LONGITUDINAL ANALYSIS OF INTELLECTUAL CAPITAL

    Directory of Open Access Journals (Sweden)

    Ienciu Nicoleta Maria

    2012-07-01

    Full Text Available The term intellectual capital has been appeared recently in economy being debated in literature since 90s playing an important role in the economic activity of an entity of nowadays. The emerging of the "new economy”, mainly driven by information and knowledge, has been identified by the Organisation for Economic Cooperation and Development as the explanation lying at the base of the development of intellectual capital, a fundamental topic in business (Hornery, 1999. One way or another, intellectual capital plays a significant role in the economic, administrative, technological and social development of contemporary times, being difficult to quantify. Many researchers avoid defining intellectual capital, but consider it the basic value of an entity, as it contains non-financial and related information (Amir and Lev, 1996; Edvinsson and Malone, 1997; Stewart, 1997; Bontis, 2001. The purpose of our paper is to highlights the contributions of researchers in the field of intellectual capital as far as the published articles in the high quality journals are concerned. Our paper presents a quantitative research by performing, on one side, a content analysis of the prestigious international journals which include papers related to intellectual capital and, on the other side, a content analysis of those articles. The originality of the present article is represented by the personal contribution to the stage of knowledge in the field of intellectual capital by means of analyzing already existent researches in the field. The results of our analysis, demonstrate that the studies conducted until now are very few by comparison to the number it should have existed until now in the literature, which demonstrates that this field of research is still at its early stage.

  2. An application of longitudinal analysis with skewed outcomes.

    Science.gov (United States)

    Azuero, Andres; Pisu, Maria; McNees, Patrick; Burkhardt, Jeffrey; Benz, Rachel; Meneses, Karen

    2010-01-01

    Longitudinal designs are indispensable to the study of change in outcomes over time and have an important role in health, social, and behavioral sciences. However, these designs present statistical challenges particularly related to accounting for the variance and covariance of the repeated measurements on the same participants and to modeling outcomes that are not normally distributed. The purpose of this study was to introduce a general methodology for longitudinal designs to address these statistical challenges and to present an example of an analysis conducted with data collected in a randomized clinical trial. In this example, the outcome of interest-monthly health-related out-of-pocket expenses incurred by breast cancer survivors-had a skewed distribution. Common statistical approaches are for longitudinal analysis using linear and generalized linear mixed models are reviewed, and the discussed methods are applied to analyze monthly health-related out-of-pocket expenses. Although standard statistical software is available to conduct longitudinal analyses, training is necessary to understand and to take advantage of the various options available for model fitting. However, knowledge of the basics of the methodology allows assimilation and incorporation into practice of evidence from the numerous studies that use these designs.

  3. Violence in Playboy magazine: a longitudinal analysis.

    Science.gov (United States)

    Scott, J E; Cuvelier, S J

    1987-08-01

    This paper analyzes the amount of violence in cartoons and pictorials from January 1954, through December 1983 in Playboy magazine. Inasmuch as the Attorney General's Commission on Pornography and Obscenity has focused upon magazines such as Playboy as potentially harmful to society because of the violence merged with sex, such an analysis is appropriate at this time. Each cartoon and pictorial for each issue of Playboy for the 30-year-period was examined for violent depictions. The average number of violent cartoons for the 30-year-period was 6.92/year or 0.58/issue. The average number of violent pictorials was less with an average of 1.89/year or 0.16/issue. The ratio of violent cartoons or pictorials to the total number of cartoons or pictorials was small. The ratio of violent cartoons to all cartoons was 25.2/1000 and for violent pictorials to all pictorials it was 8.6/1000. Moreover, the ratio of violent cartoons to total pages was 2.86/1000 and for violent pictorials 0.78/1000 pages. Although the overall number and ratio of violent cartoons and pictorials in Playboy over the 30-year-period examined was rare, a major question addressed was whether the amount of violence was increasing. Rather than a linear relation, a curvilinear relationship was observed with the amount of violence on the decrease in recent years. Although the effects of violence in sexual material is still being debated, those who argue for greater censorship of magazines such as Playboy because of its depictions of violence need a new rationale to justify their position.

  4. Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination.

    Science.gov (United States)

    Lee, Donghoon; Park, Sang Min

    2016-01-01

    To tackle the high prevalence of Hepatitis B virus (HBV) infection in North Korea, it is essential that birth doses of HBV vaccines should be administered within 24 hours of birth. As the country fails to provide a Timely Birth Dose (TBD) of HBV vaccine, the efforts of reducing the high prevalence of HBV have been significantly hampered. To examine the cost-effectiveness of vaccination strategies to prevent perinatal transmission of HBV in North Korea, we established a decision tree with a Markov model consisting of selective, universal, and the country's current vaccination program against HBV. The cost-effectiveness analysis was performed from societal and payer's perspectives and evaluated by Disability Adjusted Life Year (DALY). The results suggest that introducing the universal vaccination would prevent 1,866 cases of perinatal infections per 100,000 of the birth cohort of 2013. Furthermore, 900 cases of perinatal infections per 100,000 could be additionally averted if switching to the selective vaccination. The current vaccination is a dominated strategy both from the societal and payer's perspective. The Incremental Cost-Effectiveness Ratio (ICER) between universal and selective vaccination is $267 from the societal perspective and is reported as $273 from the payer's perspective. Based on the assumption that the 2012 Gross Domestic Product (GDP) per capita in North Korea, $582.6 was set for cost-effectiveness criteria, the result of this study indicates that selective vaccination may be a highly cost-effective strategy compared to universal vaccination.

  5. Analysis of hepatitis B vaccination behavior and vaccination willingness among migrant workers from rural China based on protection motivation theory.

    Science.gov (United States)

    Liu, Rugang; Li, Youwei; Wangen, Knut R; Maitland, Elizabeth; Nicholas, Stephen; Wang, Jian

    2016-05-03

    With China's accelerating urbanization, migrant workers comprise up to 40% of the urban population of China's largest cities. More mobile than non-migrant urban dwellers, migrants are more likely to contract and spread hepatitis B (HB) than non-migrants. Due to the mandatory system of household registration (hukou), migrants are less likely to be covered by national HB immunization programs and also to have more limited access to public health services where they work than non-migrants. Migrants form a significant sub-group in all Chinese cities posing unique public policy vaccination challenges. Using protection motivation theory (PMT), we developed and measured HB cognitive variables and analyze the factors affecting HB vaccination behavior and willingness to vaccinate by migrant workers. We propose public policy interventions to increase HB vaccination rates of migrant workers. We developed a questionnaire to collect information on the HB vaccination characteristics of 1684 respondents from 6 provinces and Beijing. Exploratory factor analysis was used to create PMT variables and a binary logistic regression model was used to analyze the factors affecting migrant workers' HB vaccination behavior and willingness to vaccinate. Vulnerability and response-efficacy were significant PMT cognition factors determining HB vaccination behavior. The HB vaccination rate for migrants decreased with increasing age and was smaller for the primary education than the high education group. The vaccination rate of the medical insurance group was significantly greater than the non-insured group, and the vaccination probability was significantly higher for the self-rated good health compared to the self-rated poor health group. Geographical birth location mattered: the vaccination rate for Beijing city and Ningxia province migrants were higher than for Hebei province and the vaccination rate was lower for migrants born far from health facilities compared to those located middle

  6. Adolescent Attitudes toward Influenza Vaccination and Vaccine Uptake in a School-Based Influenza Vaccination Intervention: A Mediation Analysis

    Science.gov (United States)

    Painter, Julia E.; Sales, Jessica M.; Pazol, Karen; Wingood, Gina M.; Windle, Michael; Orenstein, Walter A.; DiClemente, Ralph J.

    2011-01-01

    Background: School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake. Methods: Participants were…

  7. Gene set analysis for longitudinal gene expression data

    Directory of Open Access Journals (Sweden)

    Piepho Hans-Peter

    2011-07-01

    Full Text Available Abstract Background Gene set analysis (GSA has become a successful tool to interpret gene expression profiles in terms of biological functions, molecular pathways, or genomic locations. GSA performs statistical tests for independent microarray samples at the level of gene sets rather than individual genes. Nowadays, an increasing number of microarray studies are conducted to explore the dynamic changes of gene expression in a variety of species and biological scenarios. In these longitudinal studies, gene expression is repeatedly measured over time such that a GSA needs to take into account the within-gene correlations in addition to possible between-gene correlations. Results We provide a robust nonparametric approach to compare the expressions of longitudinally measured sets of genes under multiple treatments or experimental conditions. The limiting distributions of our statistics are derived when the number of genes goes to infinity while the number of replications can be small. When the number of genes in a gene set is small, we recommend permutation tests based on our nonparametric test statistics to achieve reliable type I error and better power while incorporating unknown correlations between and within-genes. Simulation results demonstrate that the proposed method has a greater power than other methods for various data distributions and heteroscedastic correlation structures. This method was used for an IL-2 stimulation study and significantly altered gene sets were identified. Conclusions The simulation study and the real data application showed that the proposed gene set analysis provides a promising tool for longitudinal microarray analysis. R scripts for simulating longitudinal data and calculating the nonparametric statistics are posted on the North Dakota INBRE website http://ndinbre.org/programs/bioinformatics.php. Raw microarray data is available in Gene Expression Omnibus (National Center for Biotechnology Information with

  8. Measuring vaccine confidence: analysis of data obtained by a media surveillance system used to analyse public concerns about vaccines.

    Science.gov (United States)

    Larson, Heidi J; Smith, David M D; Paterson, Pauline; Cumming, Melissa; Eckersberger, Elisabeth; Freifeld, Clark C; Ghinai, Isaac; Jarrett, Caitlin; Paushter, Louisa; Brownstein, John S; Madoff, Lawrence C

    2013-07-01

    The intensity, spread, and effects of public opinion about vaccines are growing as new modes of communication speed up information sharing, contributing to vaccine hesitancy, refusals, and disease outbreaks. We aimed to develop a new application of existing surveillance systems to detect and characterise early signs of vaccine issues. We also aimed to develop a typology of concerns and a way to assess the priority of each concern. Following preliminary research by The Vaccine Confidence Project, media reports (eg, online articles, blogs, government reports) were obtained using the HealthMap automated data collection system, adapted to monitor online reports about vaccines, vaccination programmes, and vaccine-preventable diseases. Any reports that did not meet the inclusion criteria--any reference to a human vaccine or vaccination campaign or programme that was accessible online--were removed from analysis. Reports were manually analysed for content and categorised by concerns, vaccine, disease, location, and source of report, and overall positive or negative sentiment towards vaccines. They were then given a priority level depending on the seriousness of the reported event and time of event occurrence. We used descriptive statistics to analyse the data collected during a period of 1 year, after refinements to the search terms and processes had been made. We analysed data from 10,380 reports (from 144 countries) obtained between May 1, 2011, and April 30, 2012. 7171 (69%) contained positive or neutral content and 3209 (31%) contained negative content. Of the negative reports, 1977 (24%) were associated with impacts on vaccine programmes and disease outbreaks; 1726 (21%) with beliefs, awareness, and perceptions; 1371 (16%) with vaccine safety; and 1336 (16%) with vaccine delivery programmes. We were able to disaggregate the data by country and vaccine type, and monitor evolution of events over time and location in specific regions where vaccine concerns were high

  9. Residuals analysis of the generalized linear models for longitudinal data.

    Science.gov (United States)

    Chang, Y C

    2000-05-30

    The generalized estimation equation (GEE) method, one of the generalized linear models for longitudinal data, has been used widely in medical research. However, the related sensitivity analysis problem has not been explored intensively. One of the possible reasons for this was due to the correlated structure within the same subject. We showed that the conventional residuals plots for model diagnosis in longitudinal data could mislead a researcher into trusting the fitted model. A non-parametric method, named the Wald-Wolfowitz run test, was proposed to check the residuals plots both quantitatively and graphically. The rationale proposedin this paper is well illustrated with two real clinical studies in Taiwan. Copyright 2000 John Wiley & Sons, Ltd.

  10. Longitudinal discriminant analysis of hemoglobin level for predicting preeclampsia.

    Science.gov (United States)

    Nasiri, Malihe; Faghihzadeh, Soghrat; Alavi Majd, Hamid; Zayeri, Farid; Kariman, Noorosadat; Safavi Ardebili, Nastaran

    2015-03-01

    Preeclampsia is one of the most serious complications during pregnancy with important effects on health of mother and fetus that causes maternal and fetal morbidity and mortality. This study was performed to evaluate whether high levels of hemoglobin may increase the risk of preeclampsia. The present study aimed to predict preeclampsia by the hemoglobin profiles through longitudinal discriminant analysis and comparing the error rate of discrimination in longitudinal and cross sectional data. In a prospective cohort study from October 2010 to July 2011, 650 pregnant women referred to the prenatal clinic of Milad Hospital in Tehran were evaluated in 3 stages. The hemoglobin level of each woman was measured in the first, second, and third trimester of pregnancy by an expert technician. The subjects were followed up to delivery and preeclampsia was the main outcome under study. The covariance pattern and linear-mixed effects models are common methods that were applied for discriminant analysis of longitudinal data. Also Student t, Mann-Whitney U, and chi-square tests were used for comparing the demographic and clinical characteristics between two groups. Statistical analyses were performed using the SAS software version 9.1. The prevalence rate of preeclampsia was 7.2% (47 women). The women with preeclampsia had a higher mean of hemoglobin values and the difference was 0.46 g/dL (P = 0.003). Also the mean of hemoglobin in the first trimester was higher than that of the second trimester, and was lower than that of the third trimester and the differences were significant (P = 0.015 and P < 0.001, respectively). The sensitivity for longitudinal data and cross-sectional data in three trimesters was 90%, 67%, 72%, and 54% and the specificity was 88%, 55%, 63%, and 50%, respectively. The levels of hemoglobin can be used to predict preeclampsia and monitoring the pregnant women and its regular measure in 3 trimesters help us to identify women at risk for preeclampsia.

  11. Dynamic classification using credible intervals in longitudinal discriminant analysis.

    Science.gov (United States)

    Hughes, David M; Komárek, Arnošt; Bonnett, Laura J; Czanner, Gabriela; García-Fiñana, Marta

    2017-10-30

    Recently developed methods of longitudinal discriminant analysis allow for classification of subjects into prespecified prognostic groups using longitudinal history of both continuous and discrete biomarkers. The classification uses Bayesian estimates of the group membership probabilities for each prognostic group. These estimates are derived from a multivariate generalised linear mixed model of the biomarker's longitudinal evolution in each of the groups and can be updated each time new data is available for a patient, providing a dynamic (over time) allocation scheme. However, the precision of the estimated group probabilities differs for each patient and also over time. This precision can be assessed by looking at credible intervals for the group membership probabilities. In this paper, we propose a new allocation rule that incorporates credible intervals for use in context of a dynamic longitudinal discriminant analysis and show that this can decrease the number of false positives in a prognostic test, improving the positive predictive value. We also establish that by leaving some patients unclassified for a certain period, the classification accuracy of those patients who are classified can be improved, giving increased confidence to clinicians in their decision making. Finally, we show that determining a stopping rule dynamically can be more accurate than specifying a set time point at which to decide on a patient's status. We illustrate our methodology using data from patients with epilepsy and show how patients who fail to achieve adequate seizure control are more accurately identified using credible intervals compared to existing methods. © 2017 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  12. Updates on the web-based VIOLIN vaccine database and analysis system.

    Science.gov (United States)

    He, Yongqun; Racz, Rebecca; Sayers, Samantha; Lin, Yu; Todd, Thomas; Hur, Junguk; Li, Xinna; Patel, Mukti; Zhao, Boyang; Chung, Monica; Ostrow, Joseph; Sylora, Andrew; Dungarani, Priya; Ulysse, Guerlain; Kochhar, Kanika; Vidri, Boris; Strait, Kelsey; Jourdian, George W; Xiang, Zuoshuang

    2014-01-01

    The integrative Vaccine Investigation and Online Information Network (VIOLIN) vaccine research database and analysis system (http://www.violinet.org) curates, stores, analyses and integrates various vaccine-associated research data. Since its first publication in NAR in 2008, significant updates have been made. Starting from 211 vaccines annotated at the end of 2007, VIOLIN now includes over 3240 vaccines for 192 infectious diseases and eight noninfectious diseases (e.g. cancers and allergies). Under the umbrella of VIOLIN, >10 relatively independent programs are developed. For example, Protegen stores over 800 protective antigens experimentally proven valid for vaccine development. VirmugenDB annotated over 200 'virmugens', a term coined by us to represent those virulence factor genes that can be mutated to generate successful live attenuated vaccines. Specific patterns were identified from the genes collected in Protegen and VirmugenDB. VIOLIN also includes Vaxign, the first web-based vaccine candidate prediction program based on reverse vaccinology. VIOLIN collects and analyzes different vaccine components including vaccine adjuvants (Vaxjo) and DNA vaccine plasmids (DNAVaxDB). VIOLIN includes licensed human vaccines (Huvax) and veterinary vaccines (Vevax). The Vaccine Ontology is applied to standardize and integrate various data in VIOLIN. VIOLIN also hosts the Ontology of Vaccine Adverse Events (OVAE) that logically represents adverse events associated with licensed human vaccines.

  13. Vaccinations

    Science.gov (United States)

    ... disease — reinforcing the importance of vaccines in your pet's preventive health care program. Are there risks? Any treatment carries some risk, but these risks should be weighed against the benefits of protecting your pet from potentially fatal diseases. ...

  14. Are Clade Specific HIV Vaccines a Necessity? An Analysis Based on Mathematical Models

    Directory of Open Access Journals (Sweden)

    Dobromir Dimitrov

    2015-12-01

    Full Text Available As HIV-1 envelope immune responses are critical to vaccine related protection, most candidate HIV vaccines entering efficacy trials are based upon a clade specific design. This need for clade specific vaccine prototypes markedly reduces the implementation of potentially effective HIV vaccines. We utilized a mathematical model to determine the effectiveness of immediate roll-out of a non-clade matched vaccine with reduced efficacy compared to constructing clade specific vaccines, which would take considerable time to manufacture and test in safety and efficacy trials. We simulated the HIV epidemic in San Francisco (SF and South Africa (SA and projected effectiveness of three vaccination strategies: i immediate intervention with a 20–40% vaccine efficacy (VE non-matched vaccine, ii delayed intervention by developing a 50% VE clade-specific vaccine, and iii immediate intervention with a non-matched vaccine replaced by a clade-specific vaccine when developed. Immediate vaccination with a non-clade matched vaccine, even with reduced efficacy, would prevent thousands of new infections in SF and millions in SA over 30 years. Vaccination with 50% VE delayed for five years needs six and 12 years in SA to break-even with immediate 20 and 30% VE vaccination, respectively, while not able to surpass the impact of immediate 40% VE vaccination over 30 years. Replacing a 30% VE with a 50% VE vaccine after 5 years reduces the HIV acquisition by 5% compared to delayed vaccination. The immediate use of an HIV vaccine with reduced VE in high risk communities appears desirable over a short time line but higher VE should be the pursued to achieve strong long-term impact. Our analysis illustrates the importance of developing surrogate markers (correlates of protection to allow bridging types of immunogenicity studies to support more rapid assessment of clade specific vaccines.

  15. Overweight, Obesity, and Depression: A Systematic Review and Meta-analysis of Longitudinal Studies

    NARCIS (Netherlands)

    Luppino, F.S.; de Wit, L.M.; Bouvy, P.F.; Stijnen, T.; Cuijpers, P.; Penninx, B.W.J.H.; Zitman, F.G.

    2010-01-01

    Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship

  16. Overweight, Obesity, and Depression A Systematic Review and Meta-analysis of Longitudinal Studies

    NARCIS (Netherlands)

    Luppino, Floriana S.; de Wit, Leonore M.; Bouvy, Paul F.; Stijnen, Theo; Cuijpers, Pim; Penninx, Brenda W. J. H.; Zitman, Frans G.

    Context: Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. Objective: To conduct a systematic review and meta-analysis on the longitudinal relationship

  17. Ontology-Based Vaccine Adverse Event Representation and Analysis.

    Science.gov (United States)

    Xie, Jiangan; He, Yongqun

    2017-01-01

    Vaccine is the one of the greatest inventions of modern medicine that has contributed most to the relief of human misery and the exciting increase in life expectancy. In 1796, an English country physician, Edward Jenner, discovered that inoculating mankind with cowpox can protect them from smallpox (Riedel S, Edward Jenner and the history of smallpox and vaccination. Proceedings (Baylor University. Medical Center) 18(1):21, 2005). Based on the vaccination worldwide, we finally succeeded in the eradication of smallpox in 1977 (Henderson, Vaccine 29:D7-D9, 2011). Other disabling and lethal diseases, like poliomyelitis and measles, are targeted for eradication (Bonanni, Vaccine 17:S120-S125, 1999).Although vaccine development and administration are tremendously successful and cost-effective practices to human health, no vaccine is 100% safe for everyone because each person reacts to vaccinations differently given different genetic background and health conditions. Although all licensed vaccines are generally safe for the majority of people, vaccinees may still suffer adverse events (AEs) in reaction to various vaccines, some of which can be serious or even fatal (Haber et al., Drug Saf 32(4):309-323, 2009). Hence, the double-edged sword of vaccination remains a concern.To support integrative AE data collection and analysis, it is critical to adopt an AE normalization strategy. In the past decades, different controlled terminologies, including the Medical Dictionary for Regulatory Activities (MedDRA) (Brown EG, Wood L, Wood S, et al., Drug Saf 20(2):109-117, 1999), the Common Terminology Criteria for Adverse Events (CTCAE) (NCI, The Common Terminology Criteria for Adverse Events (CTCAE). Available from: http://evs.nci.nih.gov/ftp1/CTCAE/About.html . Access on 7 Oct 2015), and the World Health Organization (WHO) Adverse Reactions Terminology (WHO-ART) (WHO, The WHO Adverse Reaction Terminology - WHO-ART. Available from: https://www.umc-products.com/graphics/28010.pdf

  18. Primary health care contribution to improve health outcomes in Bogota-Colombia: a longitudinal ecological analysis

    Science.gov (United States)

    2012-01-01

    Background Colombia has a highly segmented and fragmented national health system that contributes to inequitable health outcomes. In 2004 the district government of Bogota initiated a Primary Health Care (PHC) strategy to improve health care access and population health status. This study aims to analyse the contribution of the PHC strategy to the improvement of health outcomes controlling for socioeconomic variables. Methods A longitudinal ecological analysis using data from secondary sources was carried out. The analysis used data from 2003 and 2007 (one year before and 3 years after the PHC implementation). A Primary Health Care Index (PHCI) of coverage intensity was constructed. According to the PHCI, localities were classified into two groups: high and low coverage. A multivariate analysis using a Poisson regression model for each year separately and a Panel Poisson regression model to assess changes between the groups over the years was developed. Dependent variables were infant mortality rate, under-5 mortality rate, infant mortality rate due to acute diarrheal disease and pneumonia, prevalence of acute malnutrition, vaccination coverage for diphtheria, pertussis, tetanus (DPT) and prevalence of exclusive breastfeeding. The independent variable was the PHCI. Control variables were sewerage coverage, health system insurance coverage and quality of life index. Results The high PHCI localities as compared with the low PHCI localities showed significant risk reductions of under-5 mortality (13.8%) and infant mortality due to pneumonia (37.5%) between 2003 and 2007. The probability of being vaccinated for DPT also showed a significant increase of 4.9%. The risk of infant mortality and of acute malnutrition in children under-5 years was lesser in the high coverage group than in the low one; however relative changes were not statistically significant. Conclusions Despite the adverse contextual conditions and the limitations imposed by the Colombian health

  19. Cost-effectiveness analysis of quadrivalent influenza vaccine in Spain.

    Science.gov (United States)

    García, Amos; Ortiz de Lejarazu, Raúl; Reina, Jordi; Callejo, Daniel; Cuervo, Jesús; Morano Larragueta, Raúl

    2016-09-01

    Influenza has a major impact on healthcare systems and society, but can be prevented using vaccination. The World Health Organization (WHO) currently recommends that influenza vaccines should include at least two virus A and one virus B lineage (trivalent vaccine; TIV). A new quadrivalent vaccine (QIV), which includes an additional B virus strain, received regulatory approval and is now recommended by several countries. The present study estimates the cost-effectiveness of replacing TIVs with QIV for risk groups and elderly population in Spain. A static, lifetime, multi-cohort Markov model with a one-year cycle time was adapted to assess the costs and health outcomes associated with a switch from TIV to QIV. The model followed a cohort vaccinated each year according to health authority recommendations, for the duration of their lives. National epidemiological data allowed the determination of whether the B strain included in TIVs matched the circulating one. Societal perspective was considered, costs and outcomes were discounted at 3% and one-way and probabilistic sensitivity analyses were performed. Compared to TIVs, QIV reduced more influenza cases and influenza-related complications and deaths during periods of B-mismatch strains in the TIV. The incremental cost-effectiveness ratio (ICER) was 8,748€/quality-adjusted life year (QALY). One-way sensitivity analysis showed mismatch with the B lineage included in the TIV was the main driver for ICER. Probabilistic sensitivity analysis shows ICER below 30,000€/QALY in 96% of simulations. Replacing TIVs with QIV in Spain could improve influenza prevention by avoiding B virus mismatch and provide a cost-effective healthcare intervention.

  20. Longitudinal Metagenomic Analysis of Hospital Air Identifies Clinically Relevant Microbes.

    Science.gov (United States)

    King, Paula; Pham, Long K; Waltz, Shannon; Sphar, Dan; Yamamoto, Robert T; Conrad, Douglas; Taplitz, Randy; Torriani, Francesca; Forsyth, R Allyn

    2016-01-01

    We describe the sampling of sixty-three uncultured hospital air samples collected over a six-month period and analysis using shotgun metagenomic sequencing. Our primary goals were to determine the longitudinal metagenomic variability of this environment, identify and characterize genomes of potential pathogens and determine whether they are atypical to the hospital airborne metagenome. Air samples were collected from eight locations which included patient wards, the main lobby and outside. The resulting DNA libraries produced 972 million sequences representing 51 gigabases. Hierarchical clustering of samples by the most abundant 50 microbial orders generated three major nodes which primarily clustered by type of location. Because the indoor locations were longitudinally consistent, episodic relative increases in microbial genomic signatures related to the opportunistic pathogens Aspergillus, Penicillium and Stenotrophomonas were identified as outliers at specific locations. Further analysis of microbial reads specific for Stenotrophomonas maltophilia indicated homology to a sequenced multi-drug resistant clinical strain and we observed broad sequence coverage of resistance genes. We demonstrate that a shotgun metagenomic sequencing approach can be used to characterize the resistance determinants of pathogen genomes that are uncharacteristic for an otherwise consistent hospital air microbial metagenomic profile.

  1. Seropositivity to non-vaccine incorporated genotypes induced by the bivalent and quadrivalent HPV vaccines: A systematic review and meta-analysis.

    Science.gov (United States)

    Bissett, Sara L; Godi, Anna; Jit, Mark; Beddows, Simon

    2017-07-13

    Human papillomavirus vaccines have demonstrated remarkable efficacy against persistent infection and disease associated with vaccine-incorporated genotypes and a degree of efficacy against some genetically related, non-vaccine-incorporated genotypes. The vaccines differ in the extent of cross-protection against these non-vaccine genotypes. Data supporting the role for neutralizing antibodies as a correlate or surrogate of cross-protection are lacking, as is a robust assessment of the seroconversion rates against these non-vaccine genotypes. We performed a systematic review and meta-analysis of available data on vaccine-induced neutralizing antibody seropositivity to non-vaccine incorporated HPV genotypes. Of 304 articles screened, 9 were included in the analysis representing ca. 700 individuals. The pooled estimate for seropositivity against HPV31 for the bivalent vaccine (86%; 95%CI 78-91%) was higher than that for the quadrivalent vaccine (61%; 39-79%; p=0.011). The pooled estimate for seropositivity against HPV45 for the bivalent vaccine (50%; 37-64%) was also higher than that for the quadrivalent vaccine (16%; 6-36%; p=0.007). Seropositivity against HPV33, HPV52 and HPV58 were similar between the vaccines. Mean seropositivity rates across non-vaccine genotypes were positively associated with the corresponding vaccine efficacy data reported from vaccine trials. These data improve our understanding of vaccine-induced functional antibody specificity against non-vaccine incorporated genotypes and may help to parameterize vaccine-impact models and improve patient management in a post-vaccine setting. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. Safety Analysis for Pentavaccine Used in Premature Infants: Family Vaccination Centre’s Experiment

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    D. А. Novikova

    2015-01-01

    Full Text Available Combined vaccines containing non-cellular pertussis component and having low reactogenicity, increase vaccination coverage against controllable infections. However, the safety of vaccination in children dealing with health issues, as well as those having a history of premature infancy, requires additional research. The article presents reactogenicity analysis for the DTP-IPV/HIB pentavaccine during primary vaccination and revaccination of premature infants (n = 85, as well as vaccination of mature newborns (n = 1433 inoculated in accordance with the national Vaccination Calendar behind the schedule. The occurrence of post-vaccinal reactions in the premature infant group was the same as in the mature infant group and amounted to 41.2% and 45.0%; the occurrence of common reactions was 18.8% and 22.4%; local effects measured 25.8% and 27.9% respectively. Post-vaccinal reactions were either weak or moderate, not requiring treatment, and they would completely disappear by the end of the third post-vaccinal day. Simultaneous injection of pentavaccine and Hepatitis B vaccine and pneumococcal conjugate vaccine in children with a history of premature infancy, showed no influence during the post-vaccinal period. The reactogenicity of pentavaccine increased along with the vaccination ratio during the primary series of vaccinations

  3. Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination.

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    Donghoon Lee

    Full Text Available To tackle the high prevalence of Hepatitis B virus (HBV infection in North Korea, it is essential that birth doses of HBV vaccines should be administered within 24 hours of birth. As the country fails to provide a Timely Birth Dose (TBD of HBV vaccine, the efforts of reducing the high prevalence of HBV have been significantly hampered.To examine the cost-effectiveness of vaccination strategies to prevent perinatal transmission of HBV in North Korea, we established a decision tree with a Markov model consisting of selective, universal, and the country's current vaccination program against HBV. The cost-effectiveness analysis was performed from societal and payer's perspectives and evaluated by Disability Adjusted Life Year (DALY.The results suggest that introducing the universal vaccination would prevent 1,866 cases of perinatal infections per 100,000 of the birth cohort of 2013. Furthermore, 900 cases of perinatal infections per 100,000 could be additionally averted if switching to the selective vaccination. The current vaccination is a dominated strategy both from the societal and payer's perspective. The Incremental Cost-Effectiveness Ratio (ICER between universal and selective vaccination is $267 from the societal perspective and is reported as $273 from the payer's perspective.Based on the assumption that the 2012 Gross Domestic Product (GDP per capita in North Korea, $582.6 was set for cost-effectiveness criteria, the result of this study indicates that selective vaccination may be a highly cost-effective strategy compared to universal vaccination.

  4. Genome sequencing and analysis of BCG vaccine strains.

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    Wen Zhang

    Full Text Available BACKGROUND: Although the Bacillus Calmette-Guérin (BCG vaccine against tuberculosis (TB has been available for more than 75 years, one third of the world's population is still infected with Mycobacterium tuberculosis and approximately 2 million people die of TB every year. To reduce this immense TB burden, a clearer understanding of the functional genes underlying the action of BCG and the development of new vaccines are urgently needed. METHODS AND FINDINGS: Comparative genomic analysis of 19 M. tuberculosis complex strains showed that BCG strains underwent repeated human manipulation, had higher region of deletion rates than those of natural M. tuberculosis strains, and lost several essential components such as T-cell epitopes. A total of 188 BCG strain T-cell epitopes were lost to various degrees. The non-virulent BCG Tokyo strain, which has the largest number of T-cell epitopes (359, lost 124. Here we propose that BCG strain protection variability results from different epitopes. This study is the first to present BCG as a model organism for genetics research. BCG strains have a very well-documented history and now detailed genome information. Genome comparison revealed the selection process of BCG strains under human manipulation (1908-1966. CONCLUSIONS: Our results revealed the cause of BCG vaccine strain protection variability at the genome level and supported the hypothesis that the restoration of lost BCG Tokyo epitopes is a useful future vaccine development strategy. Furthermore, these detailed BCG vaccine genome investigation results will be useful in microbial genetics, microbial engineering and other research fields.

  5. Technology Resource, Distribution, and Development Characteristics of Global Influenza Virus Vaccine: A Patent Bibliometric Analysis

    Science.gov (United States)

    Liu, Long; Yan, Zhe; Tao, Lixin; Guo, Xiuhua; Luo, Yanxia; Yan, Aoshuang

    2015-01-01

    Influenza virus vaccine (IVV) is a promising research domain that is closely related to global health matters, which has been acknowledged not only by scientists and technology developers, but also by policy-makers. Meanwhile, patents encompass valuable technological information and reflect the latest technological inventions as well as the innovative capability of a nation. However, little research has examined this up-and-coming research field using patent bibliometric method. Thus, this paper (a) designs the technology classification system and search strategy for the identification of IVV; and (b) presents a longitudinal analysis of the global IVV development based on the European Patent Office (EPO) patents. Bibliometric analysis is used to rank countries, institutions, inventors and technology subfields contributing to IVV technical progress. The results show that the global trends of IVV are a multi-developing feature of variety but an uneven technical resource distribution. Although the synthetic peptide vaccine is a comparatively young field, it already demonstrates the powerful vitality and the enormous development space. With the worldwide competition increasing, all nations especially China should be looking to increase devotion, enhance capability and regard effectiveness of technological innovation. PMID:26372160

  6. Technology Resource, Distribution, and Development Characteristics of Global Influenza Virus Vaccine: A Patent Bibliometric Analysis.

    Science.gov (United States)

    Chen, Ning; Liu, Yun; Cheng, Yijie; Liu, Long; Yan, Zhe; Tao, Lixin; Guo, Xiuhua; Luo, Yanxia; Yan, Aoshuang

    2015-01-01

    Influenza virus vaccine (IVV) is a promising research domain that is closely related to global health matters, which has been acknowledged not only by scientists and technology developers, but also by policy-makers. Meanwhile, patents encompass valuable technological information and reflect the latest technological inventions as well as the innovative capability of a nation. However, little research has examined this up-and-coming research field using patent bibliometric method. Thus, this paper (a) designs the technology classification system and search strategy for the identification of IVV; and (b) presents a longitudinal analysis of the global IVV development based on the European Patent Office (EPO) patents. Bibliometric analysis is used to rank countries, institutions, inventors and technology subfields contributing to IVV technical progress. The results show that the global trends of IVV are a multi-developing feature of variety but an uneven technical resource distribution. Although the synthetic peptide vaccine is a comparatively young field, it already demonstrates the powerful vitality and the enormous development space. With the worldwide competition increasing, all nations especially China should be looking to increase devotion, enhance capability and regard effectiveness of technological innovation.

  7. Sustainable Mobility: Longitudinal Analysis of Built Environment on Transit Ridership

    Directory of Open Access Journals (Sweden)

    Dohyung Kim

    2016-10-01

    Full Text Available Given the concerns about urban mobility, traffic congestion, and greenhouse gas (GHG emissions, extensive research has explored the relationship between the built environment and transit ridership. However, the nature of aggregation and the cross-sectional approach of the research rarely provide essential clues on the potential of a transit system as a sustainable mobility option. From the perspective of longitudinal sustainability, this paper develops regression models for rail transit stations in the Los Angeles Metro system. These models attempt to identify the socio-demographic characteristics and land use features influencing longitudinal transit ridership changes. Step-wise ordinary least square (OLS regression models are used to identify factors that contribute to transit ridership changes. Those factors include the number of dwelling units, employment-oriented land uses such as office and commercial land uses, and land use balance. The models suggest a negative relationship between job and population balance with transit ridership change. They also raise a question regarding the 0.4 km radius commonly used in transit analysis. The models indicate that the 0.4 km radius is too small to capture the significant influence of the built environment on transit ridership.

  8. Integrative genomic analysis of the human immune response to influenza vaccination.

    Science.gov (United States)

    Franco, Luis M; Bucasas, Kristine L; Wells, Janet M; Niño, Diane; Wang, Xueqing; Zapata, Gladys E; Arden, Nancy; Renwick, Alexander; Yu, Peng; Quarles, John M; Bray, Molly S; Couch, Robert B; Belmont, John W; Shaw, Chad A

    2013-07-16

    Identification of the host genetic factors that contribute to variation in vaccine responsiveness may uncover important mechanisms affecting vaccine efficacy. We carried out an integrative, longitudinal study combining genetic, transcriptional, and immunologic data in humans given seasonal influenza vaccine. We identified 20 genes exhibiting a transcriptional response to vaccination, significant genotype effects on gene expression, and correlation between the transcriptional and antibody responses. The results show that variation at the level of genes involved in membrane trafficking and antigen processing significantly influences the human response to influenza vaccination. More broadly, we demonstrate that an integrative study design is an efficient alternative to existing methods for the identification of genes involved in complex traits. DOI:http://dx.doi.org/10.7554/eLife.00299.001.

  9. Potential Vaccine Targets against Rabbit Coccidiosis by Immunoproteomic Analysis.

    Science.gov (United States)

    Song, Hongyan; Dong, Ronglian; Qiu, Baofeng; Jing, Jin; Zhu, Shunxing; Liu, Chun; Jiang, Yingmei; Wu, Liucheng; Wang, Shengcun; Miao, Jin; Shao, Yixiang

    2017-02-01

    The aim of this study was to identify antigens for a vaccine or drug target to control rabbit coccidiosis. A combination of 2-dimensional electrophoresis, immunoblotting, and mass spectrometric analysis were used to identify novel antigens from the sporozoites of Eimeria stiedae . Protein spots were recognized by the sera of New Zealand rabbits infected artificially with E. stiedae . The proteins were characterized by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/TOF-MS) analysis in combination with bioinformatics. Approximately 868 protein spots were detected by silver-staining, and a total of 41 immunoreactive protein spots were recognized by anti- E. stiedae sera. Finally, 23 protein spots were successfully identified. The proteins such as heat shock protein 70 and aspartyl protease may have potential as immunodiagnostic or vaccine antigens. The immunoreactive proteins were found to possess a wide range of biological functions. This study is the first to report the proteins recognized by sera of infected rabbits with E. stiedae , which might be helpful in identifying potential targets for vaccine development to control rabbit coccidiosis.

  10. Case-control vaccine effectiveness studies: Data collection, analysis and reporting results.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    The case-control methodology is frequently used to evaluate vaccine effectiveness post-licensure. The results of such studies provide important insight into the level of protection afforded by vaccines in a 'real world' context, and are commonly used to guide vaccine policy decisions. However, the potential for bias and confounding are important limitations to this method, and the results of a poorly conducted or incorrectly interpreted case-control study can mislead policies. In 2012, a group of experts met to review recent experience with case-control studies evaluating vaccine effectiveness; we summarize the recommendations of that group regarding best practices for data collection, analysis, and presentation of the results of case-control vaccine effectiveness studies. Vaccination status is the primary exposure of interest, but can be challenging to assess accurately and with minimal bias. Investigators should understand factors associated with vaccination as well as the availability of documented vaccination status in the study context; case-control studies may not be a valid method for evaluating vaccine effectiveness in settings where many children lack a documented immunization history. To avoid bias, it is essential to use the same methods and effort gathering vaccination data from cases and controls. Variables that may confound the association between illness and vaccination are also important to capture as completely as possible, and where relevant, adjust for in the analysis according to the analytic plan. In presenting results from case-control vaccine effectiveness studies, investigators should describe enrollment among eligible cases and controls as well as the proportion with no documented vaccine history. Emphasis should be placed on confidence intervals, rather than point estimates, of vaccine effectiveness. Case-control studies are a useful approach for evaluating vaccine effectiveness; however careful attention must be paid to the collection

  11. A longitudinal intergenerational analysis of executive functions during early childhood.

    Science.gov (United States)

    Cuevas, Kimberly; Deater-Deckard, Kirby; Kim-Spoon, Jungmeen; Wang, Zhe; Morasch, Katherine C; Bell, Martha Ann

    2014-03-01

    Despite the importance of executive function (EF) in both clinical and educational contexts, the aetiology of individual differences in early childhood EF remains poorly understood. This study provides the first longitudinal intergenerational analysis of mother-child EF associations during early childhood. A group of children and their mothers (n = 62) completed age-appropriate EF tasks. Mother and child EFs were modestly correlated by 24 months of age, and this association was stable through 48 months. Importantly, maternal-child EF associations were still robust after controlling for verbal ability (potential indicator of verbal/crystallized intelligence) and maternal education (correlate of socio-economic status and verbal intelligence). Potential implications of these findings as well as underlying mechanisms of the maternal-child EF association (gene-environment interplay) are discussed. © 2013 The British Psychological Society.

  12. Longitudinal analysis of Ecuador’s Library System

    Directory of Open Access Journals (Sweden)

    Patricio Álvarez-Muñoz

    2016-12-01

    Full Text Available The success of the finest universities in the world is based to a large extent on the development of the library system. At the same time these systems are subjected to a competitive dynamic, with the aim of promoting knowledge generation. Ecuador is not exempt from this dynamic and currently finds itself in the midst of an overall development of its higher education system. The present study offers a longitudinal analysis of the current state of the university library system, based on a sample 25 of the 54 existing universities. Under consideration were administrative, technological, economic and service variables, the most important being the number of documents per student and the investment in database access. In addition, the way in which libraries acquire scientific information databases is explored, together with what is currently on offer and the level of government investment for providing database access.

  13. Economic analysis of pandemic influenza vaccination strategies in Singapore.

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    Vernon J Lee

    Full Text Available BACKGROUND: All influenza pandemic plans advocate pandemic vaccination. However, few studies have evaluated the cost-effectiveness of different vaccination strategies. This paper compares the economic outcomes of vaccination compared with treatment with antiviral agents alone, in Singapore. METHODOLOGY: We analyzed the economic outcomes of pandemic vaccination (immediate vaccination and vaccine stockpiling compared with treatment-only in Singapore using a decision-based model to perform cost-benefit and cost-effectiveness analyses. We also explored the annual insurance premium (willingness to pay depending on the perceived risk of the next pandemic occurring. PRINCIPAL FINDINGS: The treatment-only strategy resulted in 690 deaths, 13,950 hospitalization days, and economic cost of USD$497 million. For immediate vaccination, at vaccine effectiveness of >55%, vaccination was cost-beneficial over treatment-only. Vaccine stockpiling is not cost-effective in most scenarios even with 100% vaccine effectiveness. The annual insurance premium was highest with immediate vaccination, and was lower with increased duration to the next pandemic. The premium was also higher with higher vaccine effectiveness, attack rates, and case-fatality rates. Stockpiling with case-fatality rates of 0.4-0.6% would be cost-beneficial if vaccine effectiveness was >80%; while at case-fatality of >5% stockpiling would be cost-beneficial even if vaccine effectiveness was 20%. High-risk sub-groups warrant higher premiums than low-risk sub-groups. CONCLUSIONS: The actual pandemic vaccine effectiveness and lead time is unknown. Vaccine strategy should be based on perception of severity. Immediate vaccination is most cost-effective, but requires vaccines to be available when required. Vaccine stockpiling as insurance against worst-case scenarios is also cost-effective. Research and development is therefore critical to develop and stockpile cheap, readily available effective vaccines.

  14. Economic Analysis of Pandemic Influenza Vaccination Strategies in Singapore

    Science.gov (United States)

    Lee, Vernon J.; Tok, Mei Yin; Chow, Vincent T.; Phua, Kai Hong; Ooi, Eng Eong; Tambyah, Paul A.; Chen, Mark I.

    2009-01-01

    Background All influenza pandemic plans advocate pandemic vaccination. However, few studies have evaluated the cost-effectiveness of different vaccination strategies. This paper compares the economic outcomes of vaccination compared with treatment with antiviral agents alone, in Singapore. Methodology We analyzed the economic outcomes of pandemic vaccination (immediate vaccination and vaccine stockpiling) compared with treatment-only in Singapore using a decision-based model to perform cost-benefit and cost-effectiveness analyses. We also explored the annual insurance premium (willingness to pay) depending on the perceived risk of the next pandemic occurring. Principal Findings The treatment-only strategy resulted in 690 deaths, 13,950 hospitalization days, and economic cost of USD$497 million. For immediate vaccination, at vaccine effectiveness of >55%, vaccination was cost-beneficial over treatment-only. Vaccine stockpiling is not cost-effective in most scenarios even with 100% vaccine effectiveness. The annual insurance premium was highest with immediate vaccination, and was lower with increased duration to the next pandemic. The premium was also higher with higher vaccine effectiveness, attack rates, and case-fatality rates. Stockpiling with case-fatality rates of 0.4–0.6% would be cost-beneficial if vaccine effectiveness was >80%; while at case-fatality of >5% stockpiling would be cost-beneficial even if vaccine effectiveness was 20%. High-risk sub-groups warrant higher premiums than low-risk sub-groups. Conclusions The actual pandemic vaccine effectiveness and lead time is unknown. Vaccine strategy should be based on perception of severity. Immediate vaccination is most cost-effective, but requires vaccines to be available when required. Vaccine stockpiling as insurance against worst-case scenarios is also cost-effective. Research and development is therefore critical to develop and stockpile cheap, readily available effective vaccines. PMID:19771173

  15. Motivational and contextual determinants of HPV-vaccination uptake: A longitudinal study among mothers of girls invited for the HPV-vaccination

    NARCIS (Netherlands)

    Pot, M.; Keulen, H.M. van; Ruiter, R.A.C.; Eekhout, I.; Mollema, L.; Paulussen, T.W.G.M.

    2017-01-01

    Background In the Netherlands, HPV-vaccination uptake among 12-year-old girls remains to be lower (61% in 2016) than expected. The present study is about 1) replicating the extent to which social-psychological determinants found in earlier cross-sectional studies explain HPV-vaccination intention,

  16. Arguments and sources on Italian online forums on childhood vaccinations: Results of a content analysis.

    Science.gov (United States)

    Fadda, Marta; Allam, Ahmed; Schulz, Peter J

    2015-12-16

    Despite being committed to the immunization agenda set by the WHO, Italy is currently experiencing decreasing vaccination rates and increasing incidence of vaccine-preventable diseases. Our aim is to analyze Italian online debates on pediatric immunizations through a content analytic approach in order to quantitatively evaluate and summarize users' arguments and information sources. Threads were extracted from 3 Italian forums. Threads had to include the keyword Vaccin* in the title, focus on childhood vaccination, and include at least 10 posts. They had to have been started between 2008 and June 2014. High inter-coder reliability was achieved. Exploratory analysis using k-means clustering was performed to identify users' posting patterns for arguments about vaccines and sources. The analysis included 6544 posts mentioning 6223 arguments about pediatric vaccinations and citing 4067 sources. The analysis of argument posting patterns included users who published a sufficient number of posts; they generated 85% of all arguments on the forum. Dominating patterns of three groups were identified: (1) an anti-vaccination group (n=280) posted arguments against vaccinations, (2) a general pro-vaccination group (n=222) posted substantially diverse arguments supporting vaccination and (3) a safety-focused pro-vaccination group (n=158) mainly forwarded arguments that questioned the negative side effects of vaccination. The anti-vaccination group was shown to be more active than the others. They use multiple sources, own experience and media as their cited sources of information. Medical professionals were among the cited sources of all three groups, suggesting that vaccination-adverse professionals are gaining attention. Knowing which information is shared online on the topic of pediatric vaccinations could shed light on why immunization rates have been decreasing and what strategies would be best suited to address parental concerns. This suggests there is a high need for

  17. Comparative analysis of pentavalent rotavirus vaccine strains and G8 rotaviruses identified during vaccine trial in Africa.

    Science.gov (United States)

    Heylen, Elisabeth; Zeller, Mark; Ciarlet, Max; Lawrence, Jody; Steele, Duncan; Van Ranst, Marc; Matthijnssens, Jelle

    2015-10-06

    RotaTeqTM is a pentavalent rotavirus vaccine based on a bovine rotavirus genetic backbone in vitro reassorted with human outer capsid genes. During clinical trials of RotaTeqTM in Sub-Saharan Africa, the vaccine efficacy over a 2-year follow-up was lower against the genotypes contained in the vaccine than against the heterotypic G8P[6] and G8P[1] rotavirus strains of which the former is highly prevalent in Africa. Complete genome analyses of 43 complete rotavirus genomes collected during phase III clinical trials of RotaTeqTM in Sub-Saharan Africa, were conducted to gain insight into the high level of cross-protection afforded by RotaTeqTM against these G8 strains. Phylogenetic analysis revealed the presence of a high number of bovine rotavirus gene segments in these human G8 strains. In addition, we performed an in depth analysis on the individual amino acid level which showed that G8 rotaviruses were more similar to the RotaTeqTM vaccine than non-G8 strains. Because RotaTeqTM possesses a bovine genetic backbone, the high vaccine efficacy against G8 strains might be partially explained by the fact that all these strains contain a complete or partial bovine-like backbone. Altogether, this study supports the hypothesis that gene segments other than VP7 and VP4 play a role in vaccine-induced immunity.

  18. Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England.

    Science.gov (United States)

    Thorrington, Dominic; van Leeuwen, Edwin; Ramsay, Mary; Pebody, Richard; Baguelin, Marc

    2017-09-08

    As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccine (QLAIV), whilst children with contraindications receive the quadrivalent inactivated influenza vaccine (QIIV). Individuals aged younger than 65 years in the clinical risk populations and elderly individuals aged 65+ years receive either a trivalent inactivated influenza vaccine (TIIV) offering protection from two A strains and one B strain or the QIIV at the choice of their general practitioner. The cost-effectiveness of quadrivalent vaccine programmes is an open question. The original analysis that supported the paediatric programme only considered a trivalent live attenuated vaccine (LAIV). The cost-effectiveness of the QIIV to other patients has not been established. We sought to estimate the cost-effectiveness of these programmes, establishing a maximum incremental total cost per dose of quadrivalent vaccines over trivalent vaccines. We used the same mathematical model as the analysis that recommended the introduction of the paediatric influenza vaccination programme. The incremental cost of the quadrivalent vaccine is the additional cost over that of the existing trivalent vaccine currently in use. Introducing quadrivalent vaccines can be cost-effective for all targeted groups. However, the cost-effectiveness of the programme is dependent on the choice of target cohort and the cost of the vaccines: the paediatric programme is cost-effective with an increased cost of £6.36 per dose, though an extension to clinical risk individuals younger than 65 years old and further to all elderly individuals means the maximum incremental cost is £1.84 and £0.20 per dose respectively. Quadrivalent influenza vaccines will bring substantial health benefits, as they are cost-effective in

  19. A Primer on Longitudinal Data Analysis in Education. Technical Report #1320

    Science.gov (United States)

    Nese, Joseph F. T.; Lai, Cheng-Fei; Anderson, Daniel

    2013-01-01

    Longitudinal data analysis in education is the study growth over time. A longitudinal study is one in which repeated observations of the same variables are recorded for the same individuals over a period of time. This type of research is known by many names (e.g., time series analysis or repeated measures design), each of which can imply subtle…

  20. The Role of Microsimulation in Longitudinal Data Analysis

    Directory of Open Access Journals (Sweden)

    Wolf, Douglas A.

    2001-01-01

    Full Text Available EnglishMicrosimulation is well known as a tool for static analysis of tax andtransfer policies, for the generation of programmic cost estimates, and dynamic analyses of socio-economic and demographic systems. However, microsimulation also has the potential to contribute tolongitudinal data analysis in several ways, including extending the range of outputs generated by amodel, addressing several defective-data problems, and serving as a vehicle for missing-dataimputation. This paper discusses microsimulation procedures suitable for several commonly-usedstatistical models appliled to longitudinal data. It also addresses the unique role that can be playedby microsimulation in longitudinal data analysis, and the problem of accounting for the severalsources of variability associated with microsimulation procedures.FrenchLa micro-simulation est bien connu comme un outil pour l'analyse statique despolitiques d'impôts et de transfert, pour l’estimation des coûts des programmes,et pour l’analyse dynamique des systèmes socio-économiques etdémographiques. Cependant, le micro-simulation offre également despossibilités intéressantes pour l'analyse de données longitudinale, y compris ledéveloppement d’autres produites du modèle, la possibilité d’adresser desproblèmes de données déficientes, et comme véhicule pour l'imputation dedonnées manquantes. Cet article discute des procédures de micro-simulationappropriées à plusieurs modèles statistiques qui utilisent des donnéeslongitudinales. Il adresse également le rôle unique qui peut être joué parla micro-simulation dans l'analyse de données longitudinale, et le problème posépar les multiples sources de variabilité dans les procédures de micro-simulation.

  1. Effectiveness of seasonal influenza vaccines in children – a systematic review and meta-analysis

    Science.gov (United States)

    Lukšić, Ivana; Clay, Sarah; Falconer, Rachel; Pulanić, Dražen; Rudan, Igor; Campbell, Harry; Nair, Harish

    2013-01-01

    Aim To assess the efficacy and effectiveness of seasonal influenza vaccines in healthy children up to the age of 18 years. Methods MedLine, EMBASE, CENTRAL, CINAHL, WHOLIS, LILACS, and Global Health were searched for randomized controlled trials and cohort and case-control studies investigating the efficacy or effectiveness of influenza vaccines in healthy children up to the age of 18 years. The studies were assessed for their quality and data on the outcomes of influenza-like illness, laboratory-confirmed influenza, and hospitalizations were extracted. Seven meta-analyses were performed for different vaccines and different study outcomes. Results Vaccine efficacy for live vaccines, using random effects model, was as follows: (i) for similar antigen, using per-protocol analysis: 83.4% (78.3%-88.8%); (ii) for similar antigen, using intention to treat analysis: 82.5 (76.7%-88.6%); (iii) for any antigen, using per protocol analysis: 76.4% (68.7%-85.0%); (iv) for any antigen, using intention to treat analysis: 76.7% (68.8%-85.6%). Vaccine efficacy for inactivated vaccines, for similar antigen, using random effects model, was 67.3% (58.2%-77.9%). Vaccine effectiveness against influenza-like illness for live vaccines, using random effects model, was 31.4% (24.8%-39.6%) and using fixed-effect model 44.3% (42.6%-45.9%). Vaccine effectiveness against influenza-like illness for inactivated vaccines, using random effects model, was 32.5% (20.0%-52.9%) and using fixed-effect model 42.6% (38.3%-47.5%). Conclusions Influenza vaccines showed high efficacy in children, particularly live vaccines. Effectiveness was lower and the data on hospitalizations were very limited. PMID:23630141

  2. Analysis of vaccination status of preschool children in Teresina (PI), Brazil.

    Science.gov (United States)

    Fernandes, Ana Catharina Nunes; Gomes, Keila Rejane Oliveira; de Araújo, Telma Maria Evangelista; Moreira-Araújo, Regilda Saraiva dos Reis

    2015-01-01

    Immunization is a priority action of the Ministry of Health for contributing to reducing child mortality; however, studies show increased vaccination delays and non-vaccination. This study aims to analyze the immunization status of preschool children in Teresina - PI. Cross-sectional study involving 542 children, aged 2-6 years, enrolled in local public schools in four Municipal Childhood Education Centers selected at random, following the proportional division by regions of the city. Data were collected through a pre-coded and pre-tested form, in addition to scanning the children's vaccination card. For univariate descriptive statistical analysis, Pearson's χ2 Test and Fisher's Exact Test were used, and for multivariate analysis, multiple logistic regression was conducted using SPSS version 17.0. The study complied with the ethical aspects in accordance with current legislation. The frequency of delayed vaccination/non-vaccination was 24.9%. The average of non-administered vaccines was 1.7 (SD ± 1.2) and of delayed vaccines was 3.3 (SD ± 1.6). The binomial logistic regression model showed a significant association (p vaccination/non-vaccination. There was no association with the variables related to the experience of children in the vaccination room and with the implementation of the Family Health Strategy. Ensuring and strengthening primary healthcare actions are essential tools to reduce non-vaccination and vaccine delays. Professionals who care for children in vaccination rooms need to sensitize themselves to guide and encourage parents/caregivers to meet the vaccination schedules without delays or errors.

  3. Analysis of a measles epidemic; possible role of vaccine failures.

    Science.gov (United States)

    Rawls, W E; Rawls, M L; Chernesky, M A

    1975-11-22

    A measles epidemic occurred in the Greensville (Ont.) Unit schools during January and February 1975. There were 47 cases of measles in 403 students: 26 (55%) of the children had a history of being vaccinated and 18 (38%) had not been vaccinated. Among children known to have been vaccinated at less than 1 year of age 7 of 13 contracted measles, while among the 48 children who had not been vaccinated 18 contracted measles. The attack rate among vaccinees increased with increasing time since vaccination. The observations of this study as well as those of similar studies suggest that vaccine failures contributed to the genesis of the epidemic. It is recommended that all children initially vaccinated at less than 1 year of age should be revaccinated with live attenuated measles virus vaccine.

  4. Contents of Japanese pro- and anti-HPV vaccination websites: A text mining analysis.

    Science.gov (United States)

    Okuhara, Tsuyoshi; Ishikawa, Hirono; Okada, Masahumi; Kato, Mio; Kiuchi, Takahiro

    2017-09-23

    In Japan, the human papillomavirus (HPV) vaccination rate has sharply fallen to nearly 0% due to sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine's dangers. Here, we aimed to examine frequently appearing contents on pro- and anti-HPV vaccination websites. We conducted online searches via two major search engines (Google Japan and Yahoo! Japan). Targeted websites were classified as "pro," "anti," or "neutral" according to their claims, with the author(s) classified as "health professionals," "mass media," or "laypersons." We then conducted a text mining analysis. Of the 270 sites analyzed, 16 contents were identified. The most frequently appearing contents on pro websites were vaccine side effects, preventable effect of vaccination, and cause of cervical cancer. The most frequently appearing contents on anti websites were vaccine side effects, vaccine toxicity, and girls who suffer from vaccine side effects. Main disseminators of each content according to the author's expertise were also revealed. Pro-HPV vaccination websites should supplement deficient contents and respond to frequent contents on anti-HPV websites. Effective tactics are needed to better communicate susceptibility to cervical cancer, frequency of side effects, and responses to vaccine toxicity and conspiracy theories. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Systematic review of incremental non-vaccine cost estimates used in cost-effectiveness analysis on the introduction of rotavirus and pneumococcal vaccines.

    Science.gov (United States)

    De la Hoz-Restrepo, Fernando; Castañeda-Orjuela, Carlos; Paternina, Angel; Alvis-Guzman, Nelson

    2013-07-02

    To review the approaches used in the cost-effectiveness analysis (CEAs) literature to estimate the cost of expanded program on immunization (EPI) activities, other than vaccine purchase, for rotavirus and pneumococcal vaccines. A systematic review in PubMed and NHS EED databases of rotavirus and pneumococcal vaccines CEAs was done. Selected articles were read and information on how EPI costs were calculated was extracted. EPI costing approaches were classified according to the method or assumption used for estimation. Seventy-nine studies that evaluated cost effectiveness of rotavirus (n=43) or pneumococcal (n=36) vaccines were identified. In general, there are few details on how EPI costs other than vaccine procurement were estimated. While 30 studies used some measurement of that cost, only one study on pneumococcal vaccine used a primary cost evaluation (bottom-up costing analysis) and one study used a costing tool. Twenty-seven studies (17 on rotavirus and 10 on pneumococcal vaccine) assumed the non-vaccine costs. Five studies made no reference to additional costs. Fourteen studies (9 rotavirus and 5 pneumococcal) did not consider any additional EPI cost beyond vaccine procurement. For rotavirus studies, the median for non-vaccine cost per dose was US$0.74 in developing countries and US$6.39 in developed countries. For pneumococcal vaccines, the median for non-vaccine cost per dose was US$1.27 in developing countries and US$8.71 in developed countries. Many pneumococcal (52.8%) and rotavirus (60.4%) cost-effectiveness analyses did not consider additional EPI costs or used poorly supported assumptions. Ignoring EPI costs in addition to those for vaccine procurement in CEA analysis of new vaccines may lead to significant errors in the estimations of ICERs since several factors like personnel, cold chain, or social mobilization can be substantially affected by the introduction of new vaccines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Political attitudes, social participation and social mobility: a longitudinal analysis.

    Science.gov (United States)

    Paterson, Lindsay

    2008-09-01

    It is often suggested that the political attitudes and social participation which have underpinned the welfare-state democracies have depended on large amounts of upward social mobility. The demographic heterogeneity of the service class, according to this view, induced in them a willingness to lead a common political project seeking to establish a common social citizenship. As the amount of upward mobility stagnates or even begins to fall, it has then further been claimed that there might emerge a degree of ideological closure in the service class that might erode their commitment to civic values. The 1958 British birth cohort study is used to investigate this question. Longitudinal data are invaluable here because they allow us to distinguish between two hypotheses: that upward mobility as such has induced in the service class certain attitudes and propensities to participate, or that the more important influence is the early socialization through which upwardly mobile people went. The conclusion of the analysis is that, although the civic values of the service class have not depended on upward mobility, this is much more true of cognitively able people than of others, and so is dependent on the somewhat meritocratic basis of selection into the salariat.

  7. Cost-utility analysis of dengue vaccination in a country with heterogeneous risk of dengue transmission.

    Science.gov (United States)

    Orellano, Pablo Wenceslao; Reynoso, Julieta Itati; Stahl, Hans-Christian; Salomon, Oscar Daniel

    2016-01-27

    Dengue is one of the most important vector-borne diseases worldwide, and annually, nearly 390 million people are infected and 500,000 patients are hospitalized for severe dengue. Argentina has great variability in the risk of dengue transmission due to eco-climatic reasons. Currently no vaccines are available for dengue even though several vaccines are under development. The aim of this study was to estimate the cost-effectiveness of a dengue vaccine in a country with heterogeneous risk of dengue transmission like Argentina. The analysis was carried out from a societal perspective using a Markov model that included both vaccine and disease parameters. Utility was measured as disability adjusted life years (DALYs) averted, and the incremental cost-effectiveness ratio (ICER) of the vaccination was expressed in 2014 American dollars (US$) per DALY averted. One-way and probabilistic sensitivity analyses were performed to evaluate uncertainty in model outcomes, and a threshold analysis was conducted to estimate the highest possible price of the vaccine. The ICER of the vaccination program was found to be US$ 5714 per DALY averted. This value is lower than 3 times the per capita GDP of Argentina (US$ 38,619 in 2014); 54.9% of the simulations were below this value. If a vaccination program would be implemented the maximum vaccine price per dose has to be US$1.49 for a vaccination at national level or US$28.72 for a targeted vaccination in high transmission areas. These results demonstrate that vaccination against dengue would be cost-effective in Argentina, especially if carried out in predetermined regions at high risk of dengue transmission. However, these results should be interpreted with caution because the probabilistic sensitivity analysis showed that there was considerable uncertainty around the ICER value. The influence of variations in vaccine efficacy, cost and other important parameters are discussed in the text. Copyright © 2015 Elsevier Ltd. All rights

  8. Analysis Of Vaccination Campaign Against Hpv And The Perspective Of Vaccinated Population

    Directory of Open Access Journals (Sweden)

    Flávia Maria Palmeira Nunes

    2017-04-01

    Full Text Available Introduction:  The Ministry of Health has provided for the girls population aged nine to 13 years, the quadrivalent vaccine against Human Papillomavirus as a preventive measure for cancer of the cervix, with the initial proposal to achieve 80% of this population.  Objective:  To analyze the vaccine coverage and the perspective of the target population about the vaccine against the Human Papillomavirus.  Methods:  This was a quantitative and qualitative field research in descriptive character, conducted through the Information System of the National Program for Immunization and with a sample of 86 adolescents in the city of São José do Egito/PE/BR.  Results:  The vaccination coverage showed a reduction in sequence of the vaccination schedules of 19,53% in the first phase of the campaign and of 24.07% in the second phase. It was also noted that lack accurate information for more than 50% of respondents, 15.11% had local and / or systemic reactions and 89,53% of them expect positive results with the vaccine against the Human Papillomavirus.  Conclusion: The results showed a discontinuity in the prophylaxis scheme, but for the teenagers who took the vaccine there is confidence that the immunobiological has the desired effect, protecting them against viruses and future cancer of the cervix. Keywords: Health services; Vaccine; Adolescents; Human Papillomavirus.

  9. Multivariate longitudinal data analysis with mixed effects hidden Markov models.

    Science.gov (United States)

    Raffa, Jesse D; Dubin, Joel A

    2015-09-01

    Multiple longitudinal responses are often collected as a means to capture relevant features of the true outcome of interest, which is often hidden and not directly measurable. We outline an approach which models these multivariate longitudinal responses as generated from a hidden disease process. We propose a class of models which uses a hidden Markov model with separate but correlated random effects between multiple longitudinal responses. This approach was motivated by a smoking cessation clinical trial, where a bivariate longitudinal response involving both a continuous and a binomial response was collected for each participant to monitor smoking behavior. A Bayesian method using Markov chain Monte Carlo is used. Comparison of separate univariate response models to the bivariate response models was undertaken. Our methods are demonstrated on the smoking cessation clinical trial dataset, and properties of our approach are examined through extensive simulation studies. © 2015, The International Biometric Society.

  10. Cost-effectiveness of new-generation oral cholera vaccines: a multisite analysis.

    Science.gov (United States)

    Jeuland, Marc; Cook, Joseph; Poulos, Christine; Clemens, John; Whittington, Dale

    2009-09-01

    We evaluated the cost-effectiveness of a low-cost cholera vaccine licensed and used in Vietnam, using recently collected data from four developing countries where cholera is endemic. Our analysis incorporated new findings on vaccine herd protective effects. Using data from Matlab, Bangladesh, Kolkata, India, North Jakarta, Indonesia, and Beira, Mozambique, we calculated the net public cost per disability-adjusted life year avoided for three immunization strategies: 1) school-based vaccination of children 5 to 14 years of age; 2) school-based vaccination of school children plus use of the schools to vaccinate children aged 1 to 4 years; and 3) community-based vaccination of persons aged 1 year and older. We determined cost-effectiveness when vaccine herd protection was or was not considered, and compared this with commonly accepted cutoffs of gross domestic product (GDP) per person to classify interventions as cost-effective or very-cost effective. Without including herd protective effects, deployment of this vaccine would be cost-effective only in school-based programs in Kolkata and Beira. In contrast, after considering vaccine herd protection, all three programs were judged very cost-effective in Kolkata and Beira. Because these cost-effectiveness calculations include herd protection, the results are dependent on assumed vaccination coverage rates. Ignoring the indirect effects of cholera vaccination has led to underestimation of the cost-effectiveness of vaccination programs with oral cholera vaccines. Once these effects are included, use of the oral killed whole cell vaccine in programs to control endemic cholera meets the per capita GDP criterion in several developing country settings.

  11. Prevention of abortion in cattle following vaccination against bovine herpesvirus 1: A meta-analysis.

    Science.gov (United States)

    Newcomer, Benjamin W; Cofield, L Grady; Walz, Paul H; Givens, M Daniel

    2017-03-01

    Bovine herpesvirus 1 is ubiquitous in cattle populations and is the cause of several clinical syndromes including respiratory disease, genital disease, and late-term abortions. Control of the virus in many parts of the world is achieved primarily through vaccination with either inactivated or modified-live viral vaccines. The purpose of this meta-analysis was to determine the cumulative efficacy of BoHV-1 vaccination to prevent abortion in pregnant cattle. Germane articles for inclusion in the analysis were identified through four online scientific databases and the examination of three review and ten primary study article reference lists. A total of 15 studies in 10 manuscripts involving over 7500 animals were included in the meta-analysis. Risk ratio effect sizes were used in random effects, weighted meta-analyses to assess the impact of vaccination. Subgroup analyses were performed based on type of vaccine, MLV or inactivated, and the type of disease challenge, experimentally induced compared to field studies. A 60% decrease in abortion risk in vaccinated cattle was demonstrated. The greatest decrease in abortion risk was seen in studies with intentional viral challenge although vaccination also decreased abortion risk in field studies. Both inactivated and modified-live viral vaccines decreased abortion risk. This meta-analysis provides quantitative support for the benefit of bovine herpesvirus 1 vaccination in the prevention of abortion. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Randomized Trials Comparing Inactivated Vaccine After Medium- or High-titer Measles Vaccine With Standard Titer Measles Vaccine After Inactivated Vaccine: A Meta-analysis.

    Science.gov (United States)

    Aaby, Peter; Ravn, Henrik; Benn, Christine S; Rodrigues, Amabelia; Samb, Badara; Ibrahim, Salah A; Libman, Michael D; Whittle, Hilton C

    2016-11-01

    Observational studies have suggested that girls have higher mortality if their most recent immunization is an inactivated vaccine rather than a live vaccine. We therefore reanalyzed 5 randomized trials of early measles vaccine (MV) in which it was possible to compare an inactivated vaccines [after medium-titer MV (MTMV) or high-titer MV (HTMV)] and a live standard titer MV (after an initial inactivated vaccine). The trials were conducted in Sudan, Senegal, The Gambia and Guinea-Bissau. The intervention group received live MTMV or HTMV from 4 to 5 months and then an inactivated vaccine from 9 to 10 months of age; the control children received inactivated vaccine/placebo from 4 to 5 months and standard titer MV from 9 to 10 months of age. We compared mortality from 9 months until end of study at 3 to 5 years of age for children who received inactivated vaccine (after MTMV or HTMV) and standard titer MV (after inactivated vaccine), respectively. The original datasets were analyzed using a Cox proportional hazards model stratified by trial. The mortality rate ratio (MRR) was 1.38 (95% confidence interval: 1.05-1.83) after an inactivated vaccine (after MTMV or HTMV) compared with a standard titer MV (after inactivated vaccine). Girls had a MRR of 1.89 (1.27-2.80), whereas there was no effect for boys, the sex-differential effect being significant (P = 0.02). Excluding measles cases did not alter these conclusions, the MRR after inactivated vaccines (after MTMV or HTMV) being 1.40 (1.06-1.86) higher overall and 1.92 (1.29-2.86) for girls. Control for variations in national immunization schedules for other vaccines did not modify these results. After 9 months of age, all children had been immunized against measles, and mortality in girls was higher when they had received inactivated vaccines (after MTMV or HTMV) rather than live standard titer MV (after an inactivated vaccine).

  13. [Vaccine hesitancy: discourse analysis of parents who have not fully or partially vaccinated their children].

    Science.gov (United States)

    Cruz Piqueras, Maite; Rodríguez García de Cortazar, Ainhoa; Hortal Carmona, Joaquín; Padilla Bernáldez, Javier

    2017-09-16

    To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters. Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain). Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule. These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term "anti-vaccines" from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Analysis of the evidence on the efficacy and safety of CYD-TDV dengue vaccine and its potential licensing and implementation through Mexico's Universal Vaccination Program].

    Science.gov (United States)

    Hernández-Ávila, Mauricio; Lazcano-Ponce, Eduardo; Hernández-Ávila, Juan Eugenio; Alpuche-Aranda, Celia M; Rodríguez-López, Mario Henry; García-García, Lourdes; Madrid-Marina, Vicente; López Gatell-Ramírez, Hugo; Lanz-Mendoza, Humberto; Martínez-Barnetche, Jesús; Díaz-Ortega, José Luis; Ángeles-Llerenas, Angélica; Barrientos-Gutiérrez, Tonatiuh; Bautista-Arredondo, Sergio; Santos-Preciado, José Ignacio

    2016-01-01

    Dengue is a major global public health problem affecting Latin America and Mexico Prevention and control measures, focusing on epidemiological surveillance and vector control, have been partially effective and costly, thus, the development of a vaccine against dengue has created great expectations among health authorities and scientific communities worldwide. The CYD-TDV dengue vaccine produced by Sanofi-Pasteur is the only dengue vaccine evaluated in phase 3 controlled clinical trials. Notwithstanding the significant contribution to the development of a vaccine against dengue, the three phase 3 clinical studies of CYD-TDV and the meta-analysis of the long-term follow up of those studies, have provided evidence that this vaccine exhibited partial vaccine efficacy to protect against virologically confirmed dengue and lead to four considerations: a) adequate vaccine efficacy against dengue virus (DENV) infections 3 and 4, less vaccine efficacy against DENV 1 and no protection against infection by DENV 2; b) decreased vaccine efficacy in dengue seronegative individuals at the beginning of the vaccination; c) 83% and 90% protection against hospitalizations and severe forms of dengue, respectively, at 25 months follow-up; and d) increased hospitalization for dengue in the vaccinated group, in children under nine years of age at the time of vaccination, detected since the third year of follow-up. The benefit of the CYD-TDV vaccine can be summarized in the protection against infection by DENV 3 and 4, as well as protection for hospitalizations and severe cases in people over nine years, who have had previous dengue infection, working mainly as a booster. In this review we identified elements on efficacy and safety of this vaccine that must be taken into account in the licensing process and potential inclusion in the national vaccination program of Mexico. The available scientific evidence on the CYD-TDV vaccine shows merits, but also leads to relevant questions that

  15. Cost-effectiveness analysis of vaccinations and decision makings on vaccination programmes in Hong Kong: A systematic review.

    Science.gov (United States)

    Wong, Carlos K H; Liao, Qiuyan; Guo, Vivian Y W; Xin, Yiqiao; Lam, Cindy L K

    2017-05-31

    To describe and systematically review the modelling and reporting of cost-effectiveness analysis of vaccination in Hong Kong, and to identify areas for quality enhancement in future cost-effectiveness analyses. We conducted a comprehensive and systematic review of cost-effectiveness studies related to vaccination and government immunisation programmes in Hong Kong published from 1990 to 2015, through database search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of selected studies was assessed using Consolidated Health Economic Evaluation Reporting Standards checklist (CHEERS). Decision making of vaccination was obtained from Scientific Committee on Vaccine Preventable Diseases (SCVPD) and Department of Health in Hong Kong. Nine eligible studies reporting twelve comparative cost-effectiveness comparisons of vaccination programme for influenza (n=2), pneumococcal disease (n=3), influenza plus pneumococcal disease (n=1), chickenpox (n=2), Haemophilus influenzae b (n=1), hepatitis A (n=1), cervical cancer (n=1) and rotavirus (n=1) were identified. Ten comparisons (83.3%) calculated the incremental cost-effectiveness ratio (ICER) of a vaccination strategy versus status quo as outcomes in terms of cost in USD per life-years, cost per quality-adjusted life-years, or cost per disability-adjusted life-years. Among those 10 comparisons in base-case scenario, 4 evaluated interventions were cost-saving relative to status quo while the ICER estimates in 3 of the 6 remaining comparisons were far below commonly accepted threshold and WHO willingness-to-pay threshold, suggestive of very cost-effective. Seven studies were of good quality based on the CHEERS checklist; one was of moderate quality; and one was of excellent quality. The common methodological problems were characterisation of heterogeneity and reporting of study parameters. There was a paucity of cost-effectiveness models evaluating vaccination targeted to the Hong Kong population. All

  16. A quarter century of advances in the statistical analysis of longitudinal neuropsychological data.

    Science.gov (United States)

    Woodard, John L

    2017-11-01

    Over the last 25 years, there has been an unprecedented increase in federal funding for large-scale longitudinal studies, many of which collect neuropsychological or neuroimaging outcome measures. These studies have collected data from thousands of study participants across multiple waves of data collection over many years. With the increased availability of longitudinal data, data sharing policies have become more liberal, thereby offering significant opportunities for interested researchers to carry out their own longitudinal research with these data. At the same time, these opportunities have stimulated new conceptualizations of longitudinal change and have led to the development of novel approaches toward analysis of longitudinal data. My aim is to review these new conceptualizations and novel data analytic approaches. In this article, I describe the state of the field a quarter century ago with respect to available longitudinal studies, and I trace the growth of federally funded longitudinal studies over the last 25 years by describing 18 of these projects, many of which are still collecting data. In the second part of this article, I describe changes in the methods used to analyze longitudinal data, transitioning from the paired t test and repeated measures ANOVA to latent change scores, linear mixed effects modeling, and latent growth curve models. Changes in the approach to management of missing data are also discussed. Future studies should abandon traditional longitudinal analytic methods in favor of contemporary approaches given their increased power, greater accuracy, and widespread availability. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis.

    Science.gov (United States)

    Baxter, Roger; Lewis, Edwin; Goddard, Kristin; Fireman, Bruce; Bakshi, Nandini; DeStefano, Frank; Gee, Julianne; Tseng, Hung Fu; Naleway, Allison L; Klein, Nicola P

    2016-12-01

     Case reports have suggested that vaccines may trigger transverse myelitis (TM) or acute disseminated encephalomyelitis (ADEM), but the evidence for a causal association is inconclusive. We analyzed the association of immunization and subsequent development of TM or ADEM.  We identified all cases of TM and ADEM in the Vaccine Safety Datalink population. Using a case-centered method, we compared vaccination of each case to vaccination of all matched persons in the study population, who received the same type of vaccine, with respect to whether or not their vaccination occurred during a predetermined exposure interval. We calculated a risk difference (excess risk) of TM and ADEM for each vaccine.  Following nearly 64 million vaccine doses, only 7 cases of TM and 8 cases of ADEM were vaccinated during the primary exposure window 5-28 days prior to onset. For TM, there was no statistically significant increased risk of immunization. For ADEM, there was no statistically significant increased risk following any vaccine except for Tdap (adolescent and adult tetanus, reduced diphtheria, acellular pertussis) vaccine. Based on 2 exposed cases, the odds ratio for Tdap exposure 5-28 days prior to ADEM onset was 15.8 (95% confidence interval [CI], 1.2-471.6; P = .04), and the estimated excess risk was 0.385 (95% CI, -.04 to 1.16) cases per million doses.  We found no association between TM and prior immunization. There was a possible association of ADEM with Tdap vaccine, but the excess risk is not likely to be more than 1.16 cases of ADEM per million vaccines administered. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  18. A preliminary cost-effectiveness analysis of hepatitis E vaccination among pregnant women in epidemic regions.

    Science.gov (United States)

    Zhao, Yueyuan; Zhang, Xuefeng; Zhu, Fengcai; Jin, Hui; Wang, Bei

    2016-08-02

    Objective To estimate the cost-effectiveness of hepatitis E vaccination among pregnant women in epidemic regions. Methods A decision tree model was constructed to evaluate the cost-effectiveness of 3 hepatitis E virus vaccination strategies from societal perspectives. The model parameters were estimated on the basis of published studies and experts' experience. Sensitivity analysis was used to evaluate the uncertainties of the model. Results Vaccination was more economically effective on the basis of the incremental cost-effectiveness ratio (ICERpregnant women in epidemic regions; however, further studies are necessary to confirm the efficacy and safety of the hepatitis E vaccines.

  19. Efficacy of killed whole-parasite vaccines in the prevention of leishmaniasis: a meta-analysis.

    Science.gov (United States)

    Noazin, Sassan; Khamesipour, Ali; Moulton, Lawrence H; Tanner, Marcel; Nasseri, Kiumarss; Modabber, Farrokh; Sharifi, Iraj; Khalil, E A G; Bernal, Ivan Dario Velez; Antunes, Carlos M F; Smith, Peter G

    2009-07-30

    Despite decades of investigation in countries on three continents, an efficacious vaccine against Leishmania infections has not been developed. Although some indication of protection was observed in some of the controlled trials conducted with "first-generation" whole, inactivated Leishmania parasite vaccines, convincing evidence of protection was lacking. After reviewing all previously published or unpublished randomized, controlled field efficacy clinical trials of prophylactic candidate vaccines, a meta-analysis of qualified trials was conducted to evaluate whether there was some evidence of protection revealed by considering the results of all trials together. The findings indicate that the whole-parasite vaccine candidates tested do not confer significant protection against human leishmaniasis.

  20. A longitudinal study of BCG vaccination in early childhood: the development of innate and adaptive immune responses.

    Directory of Open Access Journals (Sweden)

    Yenny Djuardi

    Full Text Available BCG vaccine drives a strong T helper 1 cellular immunity which is essential for the protection against mycobacteria, however recent studies suggest that BCG vaccination can have non-specific beneficial effects unrelated to tuberculosis. In the present cohort study the development of cytokine profiles following BCG vaccination was investigated. Immune responses to PPD were assessed before vaccination and at ages of 5 months, 1 year, and 2 years, followed by BCG scar measurement at 4 years of age. BCG was shown to induce both Th1 and Th2 type responses against PPD at about 5 months of age after vaccination, and while Th1 response was sustained, Th2 responses declined over time. However, BCG scar size was strongly correlated with Th2 responses to PPD at 5 months of age. Importantly, we observed no clear effects of BCG vaccination on innate immune responses in terms of early IL-10 or TNF-α production whereas some alterations in general adaptive immune responses to PHA were observed.

  1. Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine.

    Science.gov (United States)

    Madhi, Shabir A; Izu, Alane; Nunes, Marta C; Violari, Avye; Cotton, Mark F; Jean-Philippe, Patrick; Klugman, Keith P; von Gottberg, Anne; van Niekerk, Nadia; Adrian, Peter V

    2015-05-28

    Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age. HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method. Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7. Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Exploring the role of ethnic identity on the attitudes towards HPV vaccine advertising among Puerto Ricans: A qualitative analysis

    Science.gov (United States)

    Calo, William A.; Fernández, Maria E.; Fernández-Espada, Natalie; Colón-López, Vivian

    2013-01-01

    Despite the existence of guidelines recommending vaccination against the human papillomavirus (HPV) and widespread availability of the vaccine through the Vaccines for Children program, HPV vaccination rates among island Puerto Ricans are suboptimal. Advertising plays a central role in promoting HPV vaccination by increasing awareness of and knowledge about the vaccine; however, little is known about the influence of cultural factors on the impact of HPV messages delivered through the media. The aim of this qualitative study was to explore the role of ethnic identity on the attitudes towards HPV vaccine advertising among island Puerto Ricans. Five focus groups (n=23) were conducted with parents and non-vaccinated females. Our analysis found several themes that may influence attitudes towards HPV vaccine advertising among this population: physical ethnic similarity, relevance of information, and sociocultural congruence. Findings may assist in developing culturally appropriate health promotion programs and media to promote HPV vaccination among Puerto Ricans. PMID:24052477

  3. Exploring the role of ethnic identity on the attitudes towards HPV vaccine advertising among Puerto Ricans: a qualitative analysis.

    Science.gov (United States)

    Calo, William A; Fernández, Maria E; Fernández-Espada, Natalie; Colón-López, Vivian

    2015-02-01

    Despite the existence of guidelines recommending vaccination against the human papillomavirus (HPV) and widespread availability of the vaccine through the Vaccines for Children program, HPV vaccination rates among island Puerto Ricans are suboptimal. Advertising plays a central role in promoting HPV vaccination by increasing awareness of and knowledge about the vaccine; however, little is known about the influence of cultural factors on the impact of HPV messages delivered through the media. The aim of this qualitative study was to explore the role of ethnic identity on the attitudes towards HPV vaccine advertising among island Puerto Ricans. Five focus groups (n = 23) were conducted with parents and non-vaccinated females. Our analysis found several themes that may influence attitudes towards HPV vaccine advertising among this population: physical ethnic similarity, relevance of information, and sociocultural congruence. Findings may assist in developing culturally appropriate health promotion programs and media to promote HPV vaccination among Puerto Ricans.

  4. The Evidence for Efficacy of HPV Vaccines: Investigations in Categorical Data Analysis

    Science.gov (United States)

    Gibbs, Alison L.; Goossens, Emery T.

    2013-01-01

    Recent approval of HPV vaccines and their widespread provision to young women provide an interesting context to gain experience with the application of statistical methods in current research. We demonstrate how we have used data extracted from a meta-analysis examining the efficacy of HPV vaccines in clinical trials with students in applied…

  5. A Longitudinal Analysis of Changing Job Quality and Worker ...

    African Journals Online (AJOL)

    Prior research has indicated that the nature of work has changed dramatically in recent years in response to economic shifts and an increasingly global economy. This study used non-panel longitudinal data from the International Social Survey Program (Work Orientations I and II: 1989 and 1997—survey questions on job ...

  6. Acquisition of English by Korean Children: A Longitudinal Analysis.

    Science.gov (United States)

    Lee, Eun-Joo

    1998-01-01

    Longitudinally investigated the development of interlanguage by two Korean speakers of English to better understand the second-language acquisition process. In particular it tested the aspect hypothesis that asserts that verb inflections in early interlanguage systems function primarily as markers of lexical aspect. (Author/VWL)

  7. Intimate Partner Violence and Welfare Participation: A Longitudinal Causal Analysis

    Science.gov (United States)

    Cheng, Tyrone C.

    2013-01-01

    This longitudinal study examined the temporal-ordered causal relationship between intimate partner violence (IPV), five mental disorders (depression, generalized anxiety disorder, social phobia, panic attack, posttraumatic stress disorder [PTSD]), alcohol abuse/dependence, drug abuse/ dependence, treatment seeking (from physician, counselor, and…

  8. Remarriage after Divorce: A Longitudinal Analysis of Well-Being.

    Science.gov (United States)

    Spanier, Graham B.; Furstenberg, Frank F., Jr.

    1982-01-01

    Examined data from a longitudinal study of divorce and remarriage to ascertain whether remarriage is helpful in enhancing one's well-being following marital separation. Concluded that remarriage after divorce is not associated with enhanced well-being. Moreover, no other variables were identified which appear to predict well-being following…

  9. Secondary Analysis of National Longitudinal Transition Study 2 Data

    Science.gov (United States)

    Hicks, Tyler A.; Knollman, Greg A.

    2015-01-01

    This review examines published secondary analyses of National Longitudinal Transition Study 2 (NLTS2) data, with a primary focus upon statistical objectives, paradigms, inferences, and methods. Its primary purpose was to determine which statistical techniques have been common in secondary analyses of NLTS2 data. The review begins with an…

  10. Longitudinal Analysis of Academic Burnout in Korean Middle School Students.

    Science.gov (United States)

    Kim, Boyoung; Lee, Minyoung; Kim, Keunhwa; Choi, Hyunju; Lee, Sang Min

    2015-10-01

    The purpose of the study was to investigate the longitudinal relationships between the initial values and slopes of three dimensions of burnout syndrome (i.e. emotional exhaustion, cynicism and academic inefficacy). The study utilized four-wave longitudinal data from a total of 367 (81.6% response rate) middle school students in South Korea. Comprising a 6-month interval survey, the first survey was conducted in June 2010, the second in December 2010, the third in June 2011 and the fourth in December 2011. All participants were 13-year-olds at the first and second surveys, and 14-year-olds at the third and fourth surveys. The Maslach Burnout Inventory-Student Survey was used for each survey to assess the level of academic burnout. The longitudinal data were analysed using latent growth modelling. The results of the study indicated that high initial values (intercept) for emotional exhaustion were associated with a higher rate of increase (slope) in cynicism and academic inefficacy. On the other hand, high initial values for cynicism and academic inefficacy were associated with a lower rate of increase in the other dimensions. This longitudinal study should promote understanding of burned-out students and contribute to the literature by informing the design of prevention programmes for academic burnout. Copyright © 2014 John Wiley & Sons, Ltd.

  11. Parental Influences on Young People's Sexual Behaviour: A Longitudinal Analysis

    Science.gov (United States)

    Wight, Daniel; Williamson, Lisa; Henderson, Marion

    2006-01-01

    Both family structure and processes have been associated with young people's sexual behaviour, but most studies are cross-sectional and focus on only one outcome: age at first intercourse. This paper uses longitudinal data from a survey of Scottish teenagers (N=5041) to show how low parental monitoring predicts early sexual activity for both sexes…

  12. In "Step" with HIV Vaccines? A Content Analysis of Local Recruitment Campaigns for an International HIV Vaccine Study.

    Science.gov (United States)

    Frew, Paula M; Macias, Wendy; Chan, Kayshin; Harding, Ashley C

    2009-01-01

    During the past two decades of the HIV/AIDS pandemic, several recruitment campaigns were designed to generate community involvement in preventive HIV vaccine clinical trials. These efforts utilized a blend of advertising and marketing strategies mixed with public relations and community education approaches to attract potential study participants to clinical trials (integrated marketing communications). Although more than 30,000 persons worldwide have participated in preventive HIV vaccine studies, no systematic analysis of recruitment campaigns exists. This content analysis study was conducted to examine several United States and Canadian recruitment campaigns for one of the largest-scale HIV vaccine trials to date (the "Step Study"). This study examined persuasive features consistent with the Elaboration Likelihood Model (ELM) including message content, personal relevance of HIV/AIDS and vaccine research, intended audiences, information sources, and other contextual features. The results indicated variation in messages and communication approaches with gay men more exclusively targeted in these regions. Racial/ethnic representations also differed by campaign. Most of the materials promote affective evaluation of the information through heuristic cueing. Implications for subsequent campaigns and research directions are discussed.

  13. Vaccination of children with a live-attenuated, intranasal influenza vaccine - analysis and evaluation through a Health Technology Assessment.

    Science.gov (United States)

    Andersohn, Frank; Bornemann, Reinhard; Damm, Oliver; Frank, Martin; Mittendorf, Thomas; Theidel, Ulrike

    2014-01-01

    Influenza is a worldwide prevalent infectious disease of the respiratory tract annually causing high morbidity and mortality in Germany. Influenza is preventable by vaccination and this vaccination is so far recommended by the The German Standing Committee on Vaccination (STIKO) as a standard vaccination for people from the age of 60 onwards. Up to date a parenterally administered trivalent inactivated vaccine (TIV) has been in use almost exclusively. Since 2011 however a live-attenuated vaccine (LAIV) has been approved additionally. Consecutively, since 2013 the STIKO recommends LAIV (besides TIV) for children from 2 to 17 years of age, within the scope of vaccination by specified indications. LAIV should be preferred administered in children from 2 to 6 of age. The objective of this Health Technology Assessment (HTA) is to address various research issues regarding the vaccination of children with LAIV. The analysis was performed from a medical, epidemiological and health economic perspective, as well as from an ethical, social and legal point of view. An extensive systematic database research was performed to obtain relevant information. In addition a supplementary research by hand was done. Identified literature was screened in two passes by two independent reviewers using predefined inclusion and exclusion criteria. Included literature was evaluated in full-text using acknowledged standards. Studies were graded with the highest level of evidence (1++), if they met the criteria of European Medicines Agency (EMA)-Guidance: Points to consider on applications with 1. meta-analyses; 2. one pivotal study. For the medical section, the age of the study participants ranges from 6 months to 17 years. Regarding study efficacy, in children aged 6 months to ≤7 years, LAIV is superior to placebo as well as to a vac-cination with TIV (Relative Risk Reduction - RRR - of laboratory confirmed influenza infection approx. 80% and 50%, respectively). In children aged >7 to 17

  14. Budget impact analysis of vaccination against Haemophilus influenzae type b as a part of a Pentavalent vaccine in the childhood immunization schedule of Iran.

    Science.gov (United States)

    Teimouri, Fatemeh; Kebriaeezadeh, Abbas; Zahraei, Seyed Mohsen; Gheiratian, MohammadMahdi; Nikfar, Shekoufeh

    2017-01-14

    Health decision makers need to know the impact of the development of a new intervention on the public health and health care costs so that they can plan for economic and financial objectives. The aim of this study was to determine the budget impact of adding Haemophilus influenzae type b (Hib) as a part of a Pentavalent vaccine (Hib-HBV-DTP) to the national childhood immunization schedule of Iran. An excel-based model was developed to determine the costs of including the Pentavalent vaccine in the national immunization program (NIP), comparing the present schedule with the previous one (including separate DTP and hepatitis B vaccines). The total annual costs included the cost of vaccination (the vaccine and syringe) and the cost of Hib treatment. The health outcome was the estimated annual cases of the diseases. The net budget impact was the difference in the total annual cost between the two schedules. Uncertainty about the vaccine effectiveness, vaccination coverage, cost of the vaccine, and cost of the diseases were handled through scenario analysis. The total cost of vaccination during 5 years was $18,060,463 in the previous program and $67,774,786 in the present program. Inclusion of the Pentavalent vaccine would increase the vaccination cost about $49 million, but would save approximately $6 million in the healthcare costs due to reduction of disease cases and treatment costs. The introduction of the Pentavalent vaccine resulted in a net increase in the healthcare budget expenditure across all scenarios from $43.4 million to $50.7 million. The results of this study showed that the inclusion of the Pentavalent vaccine in the NIP of Iran had a significant impact on the health care budget and increased the financial burden on the government. Budget impact of including Pentavalent vaccine in the national immunization schedule of Iranᅟ.

  15. QuantiFERON®-TB Gold In-Tube for contact screening in BCG-vaccinated adults: A longitudinal cohort study.

    Science.gov (United States)

    Muñoz, Laura; Gonzalez, Lucia; Soldevila, Laura; Dorca, Jordi; Alcaide, Fernando; Santin, Miguel

    2017-01-01

    To assess the utility of QuantiFERON®-TB Gold In-tube (QFT-GIT) for targeting preventive therapy in BCG-vaccinated contacts of tuberculosis (TB), based on its high specificity and negative predictive value for development of TB. We compared two screening strategies for TB contact tracing in two consecutive periods: the tuberculin skin test (TST) period, when all contacts were screened with the TST alone; and the QFT-GIT period, when BCG-vaccinated contacts underwent TST and QFT-GIT. Diagnosis of TB infection among BCG-vaccinated contacts relied on TST ≥5 mm in the TST period, while in the QFT-GIT period either a positive QFT-GIT or a TST ≥15 mm was required. Six hundred and sixty-one contacts were compared. In the QFT-GIT period there was a reduction in diagnoses of TB infection (77.4% vs. 51.2%; p preventive therapy prescribed (62.1% vs. 48.2%; p = 0.02) among the 290 BCG-vaccinated contacts. After a median follow-up of 5 years, cumulative incidences of TB were 0.62 and 0.29 in the TST and QFT-GIT periods respectively (p = 0.59). In BCG-vaccinated TB contacts, the addition of QFT-GIT safely reduced TB diagnosis and treatment rates without increasing the risk of subsequent active TB.

  16. Seasonal Influenza Vaccination amongst Medical Students: A Social Network Analysis Based on a Cross-Sectional Study

    National Research Council Canada - National Science Library

    Edge, Rhiannon; Heath, Joseph; Rowlingson, Barry; Keegan, Thomas J; Isba, Rachel

    2015-01-01

    .... We used a social network analysis approach to look at vaccination distribution within the network of the Lancaster Medical School students and combined these data with the students' beliefs about vaccination behaviours...

  17. Safety of Human Papillomavirus 9-Valent Vaccine: A Meta-Analysis of Randomized Trials

    Directory of Open Access Journals (Sweden)

    Ana Paula Ferreira Costa

    2017-01-01

    Full Text Available Vaccination against human papillomavirus (HPV has been progressively implemented in most developed countries for approximately 10 years. In order to increase the protection of the vaccines, a 9-valent vaccine (HPV9 was developed, which provides protection against nine types of the virus. Studies evaluating its safety are rare. Thus, we performed a meta-analysis of three clinical trials assessing adverse effects on women randomly vaccinated with HPV9 or tetravalent vaccine (HPV4, with the objective of analyzing whether the HPV9 is as safe as HPV4. An electronic data search was performed through the PubMed, Embase, Scopus, Web of Science, and SciELO databases. The studies selected 27,465 women who received one of the two vaccines. Pain (OR 1.72; 95% CI 1.62–1.82 and erythema (OR 1.29; 95% CI 1.21–1.36 occurred significantly more in the HPV9 group. However, there was no significant difference between the groups for the following adverse effects: headache (OR 1.07; 95% CI 0.99–1.15, dizziness (OR 1.09; 95% CI 0.93–1.27, and fatigue (OR 1.09; 95% CI 0.91–1.30, and the occurrence of serious events related to vaccination was similarly rare among those vaccinated. Therefore, our findings demonstrate that HPV9 in female patients is as safe as the tetravalent vaccine.

  18. Multivariate analysis of the immune response to a vaccine as an alternative to the repetition of animal challenge studies for vaccines with demonstrated efficacy.

    Science.gov (United States)

    Chapat, Ludivine; Hilaire, Florence; Bouvet, Jérome; Pialot, Daniel; Philippe-Reversat, Corinne; Guiot, Anne-Laure; Remolue, Lydie; Lechenet, Jacques; Andreoni, Christine; Poulet, Hervé; Day, Michael J; De Luca, Karelle; Cariou, Carine; Cupillard, Lionel

    2017-07-01

    The assessment of vaccine combinations, or the evaluation of the impact of minor modifications of one component in well-established vaccines, requires animal challenges in the absence of previously validated correlates of protection. As an alternative, we propose conducting a multivariate analysis of the specific immune response to the vaccine. This approach is consistent with the principles of the 3Rs (Refinement, Reduction and Replacement) and avoids repeating efficacy studies based on infectious challenges in vivo. To validate this approach, a set of nine immunological parameters was selected in order to characterize B and T lymphocyte responses against canine rabies virus and to evaluate the compatibility between two canine vaccines, an inactivated rabies vaccine (RABISIN ® ) and a combined vaccine (EURICAN ® DAPPi-Lmulti) injected at two different sites in the same animals. The analysis was focused on the magnitude and quality of the immune response. The multi-dimensional picture given by this 'immune fingerprint' was used to assess the impact of the concomitant injection of the combined vaccine on the immunogenicity of the rabies vaccine. A principal component analysis fully discriminated the control group from the groups vaccinated with RABISIN ® alone or RABISIN ® +EURICAN ® DAPPi-Lmulti and confirmed the compatibility between the rabies vaccines. This study suggests that determining the immune fingerprint, combined with a multivariate statistical analysis, is a promising approach to characterizing the immunogenicity of a vaccine with an established record of efficacy. It may also avoid the need to repeat efficacy studies involving challenge infection in case of minor modifications of the vaccine or for compatibility studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Vaccination of children with a live-attenuated, intranasal influenza vaccineanalysis and evaluation through a Health Technology Assessment

    Directory of Open Access Journals (Sweden)

    Andersohn, Frank

    2014-10-01

    Full Text Available [english] Background: Influenza is a worldwide prevalent infectious disease of the respiratory tract annually causing high morbidity and mortality in Germany. Influenza is preventable by vaccination and this vaccination is so far recommended by the (STIKO as a standard vaccination for people from the age of 60 onwards. Up to date a parenterally administered trivalent inactivated vaccine (TIV has been in use almost exclusively. Since 2011 however a live-attenuated vaccine (LAIV has been approved additionally. Consecutively, since 2013 the STIKO recommends LAIV (besides TIV for children from 2 to 17 years of age, within the scope of vaccination by specified indications. LAIV should be preferred administered in children from 2 to 6 of age. The objective of this Health Technology Assessment (HTA is to address various research issues regarding the vaccination of children with LAIV. The analysis was performed from a medical, epidemiological and health economic perspective, as well as from an ethical, social and legal point of view.Method: An extensive systematic database research was performed to obtain relevant information. In addition a supplementary research by hand was done. Identified literature was screened in two passes by two independent reviewers using predefined inclusion and exclusion criteria. Included literature was evaluated in full-text using acknowledged standards. Studies were graded with the highest level of evidence (1++, if they met the criteria of Results: For the medical section, the age of the study participants ranges from 6 months to 17 years. Regarding study efficacy, in children aged 6 months to ≤7 years, LAIV is superior to placebo as well as to a vac-cination with TIV (Relative Risk Reduction – RRR – of laboratory confirmed influenza infection approx. 80% and 50%, respectively. In children aged >7 to 17 years (= 18th year of their lives, LAIV is superior to a vaccination with TIV (RRR 32%. For this age group, no

  20. Opportunities for Prevenar 13 ® vaccine in Campania Region: a budget impact analysis

    Directory of Open Access Journals (Sweden)

    Giorgio Liguori

    2012-03-01

    Full Text Available

    Abstract:
    Background: although the efficacy of pneumococcal vaccination for the more common serotypes of Streptococcus pneumoniae has been demonstrated, the 13-valent vaccine (Prevenar 13® is still offered in different ways in the Italian regional healthcare units, and in the region of campania, some local health authorities administer the vaccine free of charge whilst others practice a co-payment.
    Methods: we performed a budget impact analysis of the possible free administration of Prevenar 13® vaccine to all newborns in the campania region, by comparing two different delivery settings, one having an active vaccination program and another in which such program was absent. during the operation of the vaccination program, the number of expected cases with 50, 80 and 100% vaccine coverage in the popula- tion was considered. the economic advantage resulting from pneumococcal diseases deemed avoidable thanks to the vaccination was compared with the costs of the vaccination program. the analysis considered the direct costs in the 2 years after implementation of the vaccination program. costs were expressed in € euros 2010.
    Results: although we did not consider the benefits achievable in the 10 years following the vaccina- tion, nor the herd effects, we showed that offering anti-pneumococcal vaccination to all newborns could give economic advantages to the region, estimated as close to 1 million euros.
    Conclusion: the use of Prevenar 13® can be considered a greatly advantageous public health strategy....

  1. GTF Transverse and Longitudinal Emittance Data Analysis Technique

    Energy Technology Data Exchange (ETDEWEB)

    2010-12-07

    The SSRL Gun Test Facility (GTF) was built to develop a high brightness electron injector for the LCLS and has been operational since 1996. Measurements at the GTF include quadrupole scan transverse emittance measurements and linac phase scan longitudinal emittance measurements. Typically the beam size is measured on a screen as a function of a quadrupole current or linac phase and the beam matrix is then fit to the measured data. Often the emittance which is the final result of the measurement is the only number reported. However, the method used to reduce the data to the final emittance value can have a significant effect on the result. This paper describes in painful detail the methods used to analyze the transverse and longitudinal emittance data collected at the GTF.

  2. Longitudinal Analysis of Early Stage Sarcopenia in Aging Rhesus Monkeys

    OpenAIRE

    McKiernan, Susan H.; Colman, Ricki; Lopez, Marisol; Beasley, T. Mark; Weindruch, Richard; Aiken, Judd M.

    2008-01-01

    We present a longitudinal study using the rhesus monkey to determine biochemical and histological changes in vastus lateralis (VL) muscle fibers and whether these changes correlate with muscle mass loss. Dual energy x-ray absorptiometry (DXA) was used to determine body weight, body fat and to estimate upper leg muscle mass in twelve adult male rhesus monkeys over 12 years. Muscle mass (MM) was evaluated at years six, nine and twelve of the study. Concurrently, VL muscle biopsy samples were co...

  3. User’s Guide for the Longitudinal Scalogram Analysis Program

    Science.gov (United States)

    1991-01-01

    Total n = 791. 0 = not passed, I = passed. Items am legal drugs , cannabis, pills, psychedelics , cocaine, and heroin. Asterisks denote longitudinal...ALERT to model stages of drug use involvement in adolescents. This revision of the original Note adds new information about the computation of...including intellectual development (e.g., Bayley, 1955), drug use involvement (e.g., Kandel, 1975), moral development (Walker, deVries, and Bichard, 1984

  4. Meta-analysis on the efficacy of foot-and-mouth disease emergency vaccination

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Boklund, Anette; Cox, S.

    2012-01-01

    The objectives of this study were to provide a summary quantification of the efficacy of FMD emergency vaccination based on a systematic review and a meta-analysis of available literature, and to further discuss the suitability of this review and meta-analysis to summarize and further interpret...... the results. Peer-reviewed, symposium, and unpublished studies were considered in the analysis. Clinical protection and virological protection against foot and mouth disease were used as parameters to assess the efficacy of emergency vaccination. The clinical protection was estimated based on the appearance...... vaccine. Fortunately, no significant bias that would alter the conclusions was encountered in the analysis. Meta-analysis showed to be a useful tool to summarize literature results from a systematic review of the efficacy of foot and mouth disease emergency vaccination....

  5. A Mechanical Analysis of Conduit Arteries Accounting for Longitudinal Residual Strains

    Science.gov (United States)

    Wang, Ruoya; Gleason, Rudolph L.

    2010-01-01

    Identification of an appropriate stress-free reference configuration is critically important in providing a reasonable prediction of the intramural stress distribution when performing biomechanical analyses on arteries. The stress-free state is commonly approximated as a radially cut ring that typically opens into a nearly circular sector, relieving much of the circumferential residual strains that exist in the traction-free configuration. An opening angle is often used to characterize this sector. In this study, we first present experimental results showing significant residual deformations in the longitudinal direction of two commonly studied arteries in the pig: the common carotid artery and the left anterior descending coronary artery. We concluded that a radially cut ring cannot completely describe the stress-free state of the arteries. Instead, we propose the use of a longitudinal opening angle, in conjunction with the traditional circumferential opening angle, to experimentally quantify the stress-free state of an artery. Secondly, we propose a new kinematic model to account for the addition of longitudinal residual strains through employing the longitudinal opening angle and performed a stress analysis. We found that with the inclusion of longitudinal residual strains in the stress analysis, the predicted circumferential stress gradient was decreased by 3-fold and the predicted longitudinal stress gradient was increased by 5.7-fold. Thus, inclusion of longitudinal residual strains has a significant effect on the predicted stress distribution in arteries. PMID:20087772

  6. A Novel Dynamic Model for Health Economic Analysis of Influenza Vaccination in the Elderly.

    Science.gov (United States)

    Mullikin, Mark; Tan, Litjen; Jansen, Jeroen P; Van Ranst, Marc; Farkas, Norbert; Petri, Eckhardt

    2015-12-01

    New vaccines are being developed to improve the efficacy of seasonal influenza immunization in elderly persons aged ≥65 years. These products require clinical and economic evaluation to aid policy decisions. To address this need, a two-part model has been developed, which we have applied to examine the potential clinical and economic impact of vaccinating elderly persons with adjuvanted trivalent inactivated influenza vaccine (aTIV) relative to conventional trivalent (TIV) and quadrivalent (QIV) vaccines. We compared outcomes in the US population for (1) aTIV in persons aged ≥65 years and QIV in all other age cohorts; (2) QIV in all cohorts; (3) TIV in all cohorts. Low, average, and high intensity seasons with low, average, and high vaccine match scenarios were compared. Probabilistic sensitivity analysis was conducted within each discrete scenario to explore the impact of variation in model inputs on potential outcomes. Assuming current vaccination coverage rates in the US population with (a) 25% better efficacy of adjuvanted versus non-adjuvanted vaccine against any strain and (b) 35% better efficacy of non-adjuvanted vaccine against matched B versus mismatched B strains, use of aTIV in persons aged ≥65 years and QIV in persons 54.5% of all circulating strains, use of QIV in all cohorts would offset the clinical benefits of aTIV. Elderly aTIV or QIV vaccination was associated with improved outcomes over non-adjuvanted TIV in many of the scenarios, particularly in low match seasons of any intensity. Total cost savings (including direct and indirect healthcare costs plus productivity impacts) with aTIV in the elderly versus QIV in the whole population ranged from $27 million (low intensity, low match) to $934 million (high intensity, high match). Univariate sensitivity analysis of relative vaccine prices in the average intensity, average match scenario indicated that aTIV could be marginally cost saving relative to QIV at the currently published Medicare

  7. A systematic review and meta-analysis for the adverse effects, immunogenicity and efficacy of Lyme disease vaccines: Guiding novel vaccine development.

    Science.gov (United States)

    Badawi, Alaa; Shering, Maria; Rahman, Shusmita; Lindsay, L Robbin

    2017-04-20

    Lyme borreliosis (LB) is the most prevalent arthropod-borne infectious disease in North America. Currently, no vaccine is available to prevent LB in humans, although monovalent and multivalent vaccines have been developed in the past. The aim of the current study is to conduct a systematic review and meta-analysis to evaluate and compare the findings from these two classes of vaccines for their reactogenicity, immunogenicity and efficacy, in the hope this may assist in the development of future vaccines. A search strategy was developed for online databases (PubMed, Ovid MEDLINE, and Embase). Search terms used were "vaccine/vaccination", "Lyme disease/Borreliosis", "clinical trial(s)" and "efficacy". Only seven clinical trials were included to compare the results of the monovalent vaccines to those of the multivalent one. Meta-analyses were conducted to evaluate the reactogenicity and immunogenicity of the two vaccine classes. Odds ratio (OR) for LB (and 95% confidence intervals; 95% CI) were calculated for the efficacy of the monovalent vaccine from three different clinical trials at different dose schedules. Incidence of redness (local adverse effect) and fever (systemic side effect) were, respectively, 6.8- and 2.9-fold significantly lower (p < 0.05) in individuals who received multivalent vaccines compared to those receiving the monovalent one. Incidences of all other local and systemic adverse effects were non-significantly lower in the multivalent vaccine compared to the monovalent vaccines. Seroprotection was comparable among individuals who received the two vaccine classes at the 30 μg dose level. Efficacy in the prevention of LB was only evaluated for the monovalent vaccines. OR of LB ranged from 0.49 (95% CI: 0.14-0.70; p < 0.005, vs. placebo) to 0.31 (95% CI: 0.26-0.63; p < 0.005) for the initial and final doses respectively, with an overall OR of 0.4 (95% CI: 0.26-0.63, p < 0.001). The current study further validates that the monovalent and multivalent

  8. Seasonal influenza vaccination in China: Landscape of diverse regional reimbursement policy, and budget impact analysis.

    Science.gov (United States)

    Yang, Juan; Atkins, Katherine E; Feng, Luzhao; Pang, Mingfan; Zheng, Yaming; Liu, Xinxin; Cowling, Benjamin J; Yu, Hongjie

    2016-11-11

    To explore the current landscape of seasonal influenza vaccination across China, and estimate the budget of implementing a national "free-at-the-point-of-care" vaccination program for priority populations recommended by the World Health Organization. In 2014 and 2016, we conducted a survey across provincial Centers for Disease Control and Prevention to collect information on regional reimbursement policies for influenza vaccination, estimated the national uptake using distributed doses of influenza vaccines, and evaluated the budget using population size and vaccine cost obtained from official websites and literatures. Regular reimbursement policies for influenza vaccination are available in 61 mutually exclusive regions, comprising 8 provinces, 45 prefectures, and 8 counties, which were reimbursed by the local Government Financial Department or Basic Social Medical Insurance (BSMI). Finance-reimbursed vaccination was offered mainly for the elderly, and school children for free in Beijing, Dongli district in Tianjin, Karamay, Shenzhen and Xinxiang cities. BSMI-reimbursement policies were limited to specific medical insurance beneficiaries with distinct differences in the reimbursement fractions. The average national vaccination coverage was just 1.5-2.2% between 2004 and 2014. A free national vaccination program for priority populations (n=416million), would cost government US$ 757million (95% CI 726-789) annually (uptake rate=20%). An increasing number of regional governments have begun to pay, partially or fully, for influenza vaccination for selected groups. However, this small-scale policy approach has failed to increase national uptake. A free, nationwide vaccination program would require a substantial annual investment. A cost-effectiveness analysis is needed to identify the most efficient methods to improve coverage. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Sensitivity analysis of longitudinal cracking on asphalt pavement using MEPDG in permafrost region

    Directory of Open Access Journals (Sweden)

    Chen Zhang

    2015-02-01

    Full Text Available Longitudinal cracking is one of the most important distresses of asphalt pavement in permafrost regions. The sensitivity analysis of design parameters for asphalt pavement can be used to study the influence of every parameter on longitudinal cracking, which can help optimizing the design of the pavement structure. In this study, 20 test sections of Qinghai–Tibet Highway were selected to conduct the sensitivity analysis of longitudinal cracking on material parameter based on Mechanistic-Empirical Pavement Design Guide (MEPDG and single factorial sensitivity analysis method. Some computer aided engineering (CAE simulation techniques, such as the Latin hypercube sampling (LHS technique and the multiple regression analysis are used as auxiliary means. Finally, the sensitivity spectrum of material parameter on longitudinal cracking was established. The result shows the multiple regression analysis can be used to determine the remarkable influence factor more efficiently and to process the qualitative analysis when applying the MEPDG software in sensitivity analysis of longitudinal cracking in permafrost regions. The effect weights of the three parameters on longitudinal cracking in descending order are air void, effective binder content and PG grade. The influence of air void on top layer is bigger than that on middle layer and bottom layer. The influence of effective asphalt content on top layer is bigger than that on middle layer and bottom layer, and the influence of bottom layer is slightly bigger than middle layer. The accumulated value of longitudinal cracking on middle layer and bottom layer in the design life would begin to increase when the design temperature of PG grade increased.

  10. Parent-son decision-making about human papillomavirus vaccination: a qualitative analysis

    Directory of Open Access Journals (Sweden)

    Alexander Andreia B

    2012-12-01

    Full Text Available Abstract Background Licensed for use in males in 2009, Human Papillomavirus (HPV vaccination rates in adolescent males are extremely low. Literature on HPV vaccination focuses on females, adult males, or parents of adolescent males, without including adolescent males or the dynamics of the parent-son interaction that may influence vaccine decision-making. The purpose of this paper is to examine the decision-making process of parent-son dyads when deciding whether or not to get vaccinated against HPV. Methods Twenty-one adolescent males (ages 13–17, with no previous HPV vaccination, and their parents/guardians were recruited from adolescent primary care clinics serving low to middle income families in a large Midwestern city. Dyad members participated in separate semi-structured interviews assessing the relative role of the parent and son in the decision regarding HPV vaccination. Interviews were recorded, transcribed, and coded using inductive content analysis. Results Parents and sons focused on protection as a reason for vaccination; parents felt a need to protect their child, while sons wanted to protect their own health. Parents and sons commonly misinterpreted the information about the vaccine. Sons were concerned about an injection in the penis, while some parents and sons thought the vaccine would protect them against other sexually transmitted infections including Herpes, Gonorrhea, and HIV. Parents and sons recalled that the vaccine prevented genital warts rather than cancer. The vaccine decision-making process was rapid and dynamic, including an initial reaction to the recommendation for HPV vaccine, discussion between parent and son, and the final vaccine decision. Provider input was weighed in instances of initial disagreement. Many boys felt that this was the first health care decision that they had been involved in. Dyads which reported shared decision-making were more likely to openly communicate about sexual issues than those

  11. Budget impact and cost-utility analysis of universal infant rotavirus vaccination in Spain.

    Science.gov (United States)

    Imaz, Iñaki; Rubio, Beltrán; Cornejo, Ana M; González-Enríquez, Jesús

    2014-04-01

    Rotavirus is not included in the Spanish mass infant vaccination schedule but has also not been economically evaluated for its inclusion. We analysed cost-utility of the universal infant rotavirus vaccination using RotaTeq® versus no vaccination in Spain. We also carried out a budget impact analysis and determined the effect on results of different variables introduced in the model. A deterministic Markov model was built considering loss of quality of life for children and their parents, and introducing direct and indirect costs updated to 2011. The introduction of the vaccination using RotaTeq® as a universal infant vaccination would increase the annual health care budget in 10.43 million euro and would result in a gain of an additional Quality Adjusted Life Year at a cost of 280,338€ from the healthcare system perspective and 210,167€ from the societal perspective. The model was stable to variable modifications. To sum up, according to our model and estimates, the introduction of a universal infant rotavirus vaccination with RotaTeq® in Spain would cause a large impact on the health care budget and would not be efficient unless significant variations in vaccine price, vaccine efficacy and/or utilities took place. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Cost-utility analysis of a nationwide vaccination programme against serogroup B meningococcal disease in Israel.

    Science.gov (United States)

    Ginsberg, Gary M; Block, Colin; Stein-Zamir, Chen

    2016-07-01

    Using cost-utility analysis, to evaluate whether or not to adopt a Neisseria meningitidis serogroup B vaccination programme for Israeli children. Epidemiological, demographic, health service utilisation and economic data were integrated into a spreadsheet model to calculate the cost per averted disability-adjusted life year (DALY) of the intervention. Assuming 78 % vaccine efficacy with no herd immunity, vaccination will prevent 223 cases and 22 deaths over a 100-year period. Based on vaccine price of $60 per dose, total intervention costs ($315,400,000) are partially offset by a $22,700,000 reduction in treatment and sequelae costs as a result of decreased morbidity. The intervention was not cost-effective since the net cost ($292,700,000) per averted DALY gained (1249 mostly due to decreased mortality) was $234,394. Additional two dose catch-up programmes vaccinating children in cohorts aged 1-2 to 1-13 were also not cost-effective. The vaccination will become cost-effective if vaccine costs fall below $19.44 per dose. However, in identified high risk areas, the vaccine would be cost-effective and could be recommended for use both with and without catch-up campaigns.

  13. Parental attitudes towards measles vaccination in the canton of Aargau, Switzerland: a latent class analysis.

    Science.gov (United States)

    Weiss, Carine; Schröpfer, Daniel; Merten, Sonja

    2016-08-11

    Despite the successes of routine national childhood vaccination programmes, measles remains a public health concern. The purpose of this paper is to investigate how patterns of parental attitudes are linked to the decision-making process for or against MMR vaccination. This exploratory study was designed to identify distinct patterns of attitudes towards or against measles vaccination through Latent Class Analysis (LCA) in a sub-sample of mothers living in the canton of Aargau in Switzerland. Parents of young children below 36 months of age were randomly selected through parents' counsellors' registries. Among other questions, respondents were asked to state their agreement in response to 14 belief statements regarding measles vaccination on a 5-point Likert scale. To identify groups of parents showing distinct patterns of attitudes and beliefs regarding measles vaccination, we used Latent Class Analysis (LCA). The LCA showed three classes of parents with different attitudes and believes towards measles vaccination: The biggest group (class 1) are those having positive attitudes towards immunisation, followed by the second biggest group (class 2) which is characterised by having fearful attitudes and by showing uncertainty about immunisation. The third group (class 3) shows distinct patterns of critical attitudes against immunisation. Within this group over 90 % agree or totally agree that immunisation is an artificial intrusion into the natural immune system and therefore want to vaccinate their children only if necessary. We find that parents in the Canton Aargau who hesitate to vaccinate their children against measles, mumps and rubella show distinct opinions and attitudes. Health professionals should be aware of these perceptions to tailor their messages accordingly and positively influence these parents to vaccinate their children. Special attention needs to be given to those parents who are planning to vaccinate their children but are not following the

  14. Application of pattern mixture models to address missing data in longitudinal data analysis using SPSS.

    Science.gov (United States)

    Son, Heesook; Friedmann, Erika; Thomas, Sue A

    2012-01-01

    Longitudinal studies are used in nursing research to examine changes over time in health indicators. Traditional approaches to longitudinal analysis of means, such as analysis of variance with repeated measures, are limited to analyzing complete cases. This limitation can lead to biased results due to withdrawal or data omission bias or to imputation of missing data, which can lead to bias toward the null if data are not missing completely at random. Pattern mixture models are useful to evaluate the informativeness of missing data and to adjust linear mixed model (LMM) analyses if missing data are informative. The aim of this study was to provide an example of statistical procedures for applying a pattern mixture model to evaluate the informativeness of missing data and conduct analyses of data with informative missingness in longitudinal studies using SPSS. The data set from the Patients' and Families' Psychological Response to Home Automated External Defibrillator Trial was used as an example to examine informativeness of missing data with pattern mixture models and to use a missing data pattern in analysis of longitudinal data. Prevention of withdrawal bias, omitted data bias, and bias toward the null in longitudinal LMMs requires the assessment of the informativeness of the occurrence of missing data. Missing data patterns can be incorporated as fixed effects into LMMs to evaluate the contribution of the presence of informative missingness to and control for the effects of missingness on outcomes. Pattern mixture models are a useful method to address the presence and effect of informative missingness in longitudinal studies.

  15. A cost-utility analysis of cervical cancer vaccination in preadolescent Canadian females

    Directory of Open Access Journals (Sweden)

    Merid Maraki

    2009-10-01

    Full Text Available Abstract Background Despite the fact that approximately 70% of Canadian women undergo cervical cancer screening at least once every 3 years, approximately 1,300 women were diagnosed with cervical cancer and approximately 380 died from it in 2008. This study estimates the effectiveness and cost-effectiveness of vaccinating 12-year old Canadian females with an AS04-adjuvanted cervical cancer vaccine. The indirect effect of vaccination, via herd immunity, is also estimated. Methods A 12-health-state 1-year-cycle Markov model was developed to estimate lifetime HPV related events for a cohort of 12-year old females. Annual transition probabilities between health-states were derived from published literature and Canadian population statistics. The model was calibrated using Canadian cancer statistics. From a healthcare perspective, the cost-effectiveness of introducing a vaccine with efficacy against HPV-16/18 and evidence of cross-protection against other oncogenic HPV types was evaluated in a population undergoing current screening practices. The base-case analysis included 70% screening coverage, 75% vaccination coverage, $135/dose for vaccine, and 3% discount rate on future costs and health effects. Conservative herd immunity effects were taken into account by estimated HPV incidence using a mathematical model parameterized by reported age-stratified sexual mixing data. Sensitivity analyses were performed to address parameter uncertainties. Results Vaccinating 12-year old females (n = 100,000 was estimated to prevent between 390-633 undiscounted cervical cancer cases (reduction of 47%-77% and 168-275 undiscounted deaths (48%-78% over their lifetime, depending on whether or not herd immunity and cross-protection against other oncogenic HPV types were included. Vaccination was estimated to cost $18,672-$31,687 per QALY-gained, the lower range representing inclusion of cross-protective efficacy and herd immunity. The cost per QALY-gained was most

  16. Quantitative microbiological data analysis of a Campylobacter vaccination trial

    DEFF Research Database (Denmark)

    Garcia Clavero, Ana Belén; Bahrndorff, Simon; Hald, Birthe

    . The objective of the present trial was to assess whether or not a vaccine candidate could give a 2 logs reduction of the numbers of Campylobacter in broilers. Sample size calculations indicated the use of 400 animals (200 vaccinated and 200 controls). The experiment was conducted in four different rotations......Campylobacter jejuni is considered the main pathogen causing human campylobacteriosis and poultry has been identified as one of the main risk factors. Strategies that aim to control Campylobacter in poultry such as vaccination strategies could reduce the incidence of human campylobacteriosis...... using 8 incubators per rotation with 10 chickens in each incubator. The vaccination treatment was randomly assigned at incubator level. Broilers were challenged with C. jejuni at day 31 and faecal/caecum samples were collected at slaughter at day 42 and processed in the laboratory. To illustrate...

  17. Peer Victimization, Depressive Symptoms, and Substance Use: A Longitudinal Analysis.

    Science.gov (United States)

    Earnshaw, Valerie A; Elliott, Marc N; Reisner, Sari L; Mrug, Sylvie; Windle, Michael; Emery, Susan Tortolero; Peskin, Melissa F; Schuster, Mark A

    2017-06-01

    Peer victimization is common among youth and associated with substance use. Yet, few studies have examined these associations longitudinally or the psychological processes whereby peer victimization leads to substance use. The current study examined whether peer victimization in early adolescence is associated with alcohol, marijuana, and tobacco use in mid- to late adolescence, as well as the role of depressive symptoms in these associations. Longitudinal data were collected between 2004 and 2011 from 4297 youth in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Data were analyzed by using structural equation modeling. The hypothesized model fit the data well (Root Mean Square Error of Approximation [RMSEA] = 0.02; Comparative Fit Index [CFI] = 0.95). More frequent experiences of peer victimization in the fifth grade were associated with greater depressive symptoms in the seventh grade (B[SE] = 0.03[0.01]; P peer victimization was indirectly associated with tenth-grade substance use via the mediator of seventh-grade depressive symptoms, including alcohol use (B[SE] = 0.01[0.01]; P = .006), marijuana use (B[SE] = 0.01[0.01]; P peer victimization in the fifth grade were more likely to use substances in the tenth grade, showing that experiences of peer victimization in early adolescence may have a lasting impact by affecting substance use behaviors during mid- to late adolescence. Interventions are needed to reduce peer victimization among youth and to support youth who have experienced victimization. Copyright © 2017 by the American Academy of Pediatrics.

  18. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    OpenAIRE

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-01-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of tempora...

  19. Media content about vaccines in the United States and Canada, 2012-2014: An analysis using data from the Vaccine Sentimeter.

    Science.gov (United States)

    Powell, Guido Antonio; Zinszer, Kate; Verma, Aman; Bahk, Chi; Madoff, Lawrence; Brownstein, John; Buckeridge, David

    2016-12-07

    A system for monitoring vaccine-related media content was previously developed and studied from an international perspective. This monitoring approach could also have value at a regional level, but it has yet to be evaluated at this scale. We examined regional patterns of vaccine-related media topics and sentiment in the US and Canada. We extracted vaccine-relevant US and Canadian online media reports between June 2012 and October 2014 from the Vaccine Sentimeter, a HealthMap-based automated media monitoring system for news aggregators and blogs. We analyzed regional distributions of reports about vaccines, categories (i.e., topics), sentiment, and measles outbreaks. The Vaccine Sentimeter captured 10,715 reports during the study period. Negative sentiment was highest in reports about vaccine safety (47%), Hepatitis B (19%), and Vermont (18%). Analyses of measles outbreaks revealed geographical variation in media content. For example, religious beliefs were mentioned in 27% of measles reports in Texas and 22% of British Columbia reports, but there were no references to religion in media on measles from California. A regional analysis of online sentiment towards vaccine can provide insights that may give US and Canadian public health practitioners a deeper understanding of media influences on vaccine choices in their regions and consequently lead to more effective public health action. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Seasonal Influenza Vaccination amongst Medical Students: A Social Network Analysis Based on a Cross-Sectional Study.

    Science.gov (United States)

    Edge, Rhiannon; Heath, Joseph; Rowlingson, Barry; Keegan, Thomas J; Isba, Rachel

    2015-01-01

    The Chief Medical Officer for England recommends that healthcare workers have a seasonal influenza vaccination in an attempt to protect both patients and NHS staff. Despite this, many healthcare workers do not have a seasonal influenza vaccination. Social network analysis is a well-established research approach that looks at individuals in the context of their social connections. We examine the effects of social networks on influenza vaccination decision and disease dynamics. We used a social network analysis approach to look at vaccination distribution within the network of the Lancaster Medical School students and combined these data with the students' beliefs about vaccination behaviours. We then developed a model which simulated influenza outbreaks to study the effects of preferentially vaccinating individuals within this network. Of the 253 eligible students, 217 (86%) provided relational data, and 65% of responders had received a seasonal influenza vaccination. Students who were vaccinated were more likely to think other medical students were vaccinated. However, there was no clustering of vaccinated individuals within the medical student social network. The influenza simulation model demonstrated that vaccination of well-connected individuals may have a disproportional effect on disease dynamics. This medical student population exhibited vaccination coverage levels similar to those seen in other healthcare groups but below recommendations. However, in this population, a lack of vaccination clustering might provide natural protection from influenza outbreaks. An individual student's perception of the vaccination coverage amongst their peers appears to correlate with their own decision to vaccinate, but the directionality of this relationship is not clear. When looking at the spread of disease within a population it is important to include social structures alongside vaccination data. Social networks influence disease epidemiology and vaccination campaigns

  1. Economic Evaluation and Budget Impact Analysis of Vaccination against Haemophilus influenzae Type b Infection in Thailand

    Directory of Open Access Journals (Sweden)

    Surachai Kotirum

    2017-11-01

    Full Text Available Current study aimed to estimate clinical and economic outcomes of providing the Haemophilus influenzae type b (Hib vaccination as a national vaccine immunization program in Thailand. A decision tree combined with Markov model was developed to simulate relevant costs and health outcomes covering lifetime horizon in societal and health care payer perspectives. This analysis considered children aged under 5 years old whom preventive vaccine of Hib infection are indicated. Two combined Hib vaccination schedules were considered: three-dose series (3 + 0 and three-dose series plus a booster does (3 + 1 compared with no vaccination. Budget impact analysis was also performed under Thai government perspective. The outcomes were reported as Hib-infected cases averted and incremental cost-effectiveness ratios (ICERs in 2014 Thai baht (THB ($ per quality-adjusted life year (QALY gained. In base-case scenario, the model estimates that 3,960 infected cases, 59 disability cases, and 97 deaths can be prevented by national Hib vaccination program. The ICER for 3 + 0 schedule was THB 1,099 ($34 per QALY gained under societal perspective. The model was sensitive to pneumonia incidence among aged under 5 years old and direct non-medical care cost per episode of Hib pneumonia. Hib vaccination is very cost-effective in the Thai context. The budget impact analysis showed that Thai government needed to invest an additional budget of 110 ($3.4 million to implement Hib vaccination program. Policy makers should consider our findings for adopting this vaccine into national immunization program.

  2. A Multiple Streams analysis of the decisions to fund gender-neutral HPV vaccination in Canada.

    Science.gov (United States)

    Shapiro, Gilla K; Guichon, Juliet; Prue, Gillian; Perez, Samara; Rosberger, Zeev

    2017-07-01

    In Canada, the human papillomavirus (HPV) vaccine is licensed and recommended for females and males. Although all Canadian jurisdictions fund school-based HPV vaccine programs for girls, only six jurisdictions fund school-based HPV vaccination for boys. The research aimed to analyze the factors that underpin government decisions to fund HPV vaccine for boys using a theoretical policy model, Kingdon's Multiple Streams framework. This approach assesses policy development by examining three concurrent, but independent, streams that guide analysis: Problem Stream, Policy Stream, and Politics Stream. Analysis from the Problem Stream highlights that males are affected by HPV-related diseases and are involved in transmitting HPV infection to their sexual partners. Policy Stream analysis makes clear that while the inclusion of males in HPV vaccine programs is suitable, equitable, and acceptable; there is debate regarding cost-effectiveness. Politics Stream analysis identifies the perspectives of six different stakeholder groups and highlights the contribution of government officials at the provincial and territorial level. Kingdon's Multiple Streams framework helps clarify the opportunities and barriers for HPV vaccine policy change. This analysis identified that the interpretation of cost-effectiveness models and advocacy of stakeholders such as citizen-advocates and HPV-affected politicians have been particularly important in galvanizing policy change. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A cost-effectiveness analysis of universal childhood hepatitis A vaccination in China.

    Science.gov (United States)

    Zhuang, Gui-Hua; Pan, Xin-Juan; Wang, Xue-Liang

    2008-08-18

    The socioeconomic improvement has impacted hepatitis A virus (HAV) infection with a shift from high to intermediate endemicity in many parts of China. The first China-developed inactivated hepatitis A vaccine, with significantly low price, was licensed in 2002, prompting us to evaluate whether universal childhood vaccination is advisable now in China. We considered vaccination scheduled at ages 12 and 18 months for all healthy children, and assumed that a single cohort was enrolled in 2005. A Markov model was used to predict hepatitis A outcomes and costs. Vaccination was compared with no vaccination, and the cost-effectiveness of vaccination was evaluated from the health system and the societal perspectives. The analysis was run separately in five regions (covering all the 31 provinces of Mainland China) defined by anti-HAV prevalence (around 50%, 50-69%, 70-79%, 80-89% and 90%-). The study projects that with the Chinese low-cost vaccine, vaccination could gain quality adjusted life years (QALYs) through the whole country and save health system or societal costs in the lowest, lower, intermediate and higher infection regions. Vaccination should also be cost-effective in the highest infection region because of low additional costs per QALY gained. However, vaccination would increase the probability of death due to hepatitis A in the highest and higher infection regions by 38 and 37 per million enrolled, respectively, and as vaccine protection loss increases the risk would also occur in intermediate and lower infection regions. The trend that the lower infection level the region has, the more cost-effective vaccination would be is obvious. Sensitivity analyses prove that our conclusions are robust. Considering the potential risk of vaccination, as well as unbalanced socioeconomic developments and significant differences in HAV infection through the whole country, the study suggests that universal childhood hepatitis A vaccination should be first administrated in

  4. [Mechanics and effects of European reference pricing for vaccines in Germany according to §130a Abs. 2 SGB V: an analysis using the example of influenza vaccines].

    Science.gov (United States)

    Barth, J; Hammerschmidt, T; Vollmar, J; Bierbaum, M; Schöffski, O

    2014-04-01

    On 01 January 2011 the bill for the reorganisation of the pharmaceutical market became effective. Since that time there is a European reference pricing (ERP) system for vaccines in order to bring down the German vaccine prices to an assumed lower European level. This study describes the implementation, functioning and effect of this new system. For influenza vaccines the impact of ERP on the price level and spread of prices is analysed. The description of the mechanism is based on the law and corresponding regulations of the head association of sickness funds (GKV-SV). The analysis of vaccine prices is based on the data of the i:data report (status of 01 September 2011) of ifap Service Institute. The European reference price is calculated as the average price of the manufacturer-selling-prices of the corresponding vaccine in the 4 countries of the European Union whose gross national income comes closest to the German one and in which the vaccine is distributed. The relied prices are weighted by sales and purchasing power parities of the respective countries. This analysis suggests that in particular the practical implementation of the reference price system should be further improved and specified. The calculation of the reference prices should ensure price comparability. In addition, significant problems remain in the deduction of discounts, because no distinction is made in the documentation of vaccinating doctors, whether vaccination was performed as a compulsory or statutory benefit. The comparison of the manufacturer-selling-prices of individual influenza vaccines with the corresponding reference prices shows an enlargement of the existing price differences, which have evolved in a competitive environment, after the implementation of the reference pricing -system. There is still a need for improvement in implementing the reference pricing system. In the most competitive vaccine market of influenza vaccines, the ERP-system lowers the prices, but seems to

  5. A meta-analysis of experimental studies of attenuated Schistosoma mansoni vaccines in the mouse model

    Directory of Open Access Journals (Sweden)

    Mizuho eFukushige

    2015-02-01

    Full Text Available Schistosomiasis is a water-borne, parasitic disease of major public health importance. There has been considerable effort for several decades towards the development of a vaccine against the disease. Numerous mouse experimental studies using attenuated Schistosoma mansoni parasites for vaccination have been published since the 1960s. However, to date, there has been no systematic review or meta-analysis of these data. The aim of this study is to identify measurable experimental conditions that affect the level of protection against re-infection with S. mansoni in mice vaccinated with radiation attenuated cercariae. Following a systematic review, a total of 755 observations were extracted from 105 articles (published 1963-2007 meeting the searching criteria. Random effects meta-regression models were used to identify the influential predictors.Three predictors were found to have statistically significant effects on the level of protection from vaccination: increasing numbers of immunizing parasites had a positive effect on fraction of protection whereas increasing radiation dose and time to challenge infection had negative effects. Models showed that the irradiated cercariae vaccine has the potential to achieve protection as high as 78% with a single dose vaccination. This declines slowly over time but remains high for at least 8 months after the last immunization. These findings provide insights into the optimal delivery of attenuated parasite vaccination and into the nature and development of protective vaccine induced immunity against schistosomiasis which may inform the formulation of human vaccines and the predicted duration of protection and thus frequency of booster vaccines.

  6. Preparation of an Oral Vaccine by Proteome Analysis and Molecular Display Technology.

    Science.gov (United States)

    Shibasaki, Seiji; Ueda, Mitsuyoshi

    2017-01-01

    In recent years, genetic engineering and protein expression technologies have promoted the development of recombinant protein vaccines. To accelerate the development of efficient vaccines for mycosis, screening candidate antigens, and determining the optimal route of administration are indispensable steps. Two methods for identifying novel antigens and producing antigens specific to Candida albicans, as a model causative pathogen of mycosis, are discussed in this chapter. Specifically, the application of liquid chromatography/tandem mass spectrometry using a long monolithic column for proteome analysis to identify virulence factors of C. albicans, followed by molecular display technology to produce an oral vaccine using antigens found by the proteomic study, is described.

  7. Differentiation of BHV-1 isolates from vaccine virus by high-resolution melting analysis.

    Science.gov (United States)

    Ostertag-Hill, Claire; Fang, Liang; Izume, Satoko; Lee, Megan; Reed, Aimee; Jin, Ling

    2015-02-16

    An efficacious bovine herpesvirus type-1 (BHV-1) vaccine has been used for many years. However, in the past few years, abortion and respiratory diseases have occurred after administration of the modified live vaccine. To investigate whether BHV-1 isolates from disease outbreaks are identical to those of the vaccines used, selected regions of the BHV-1 genome were investigated by high-resolution melting (HRM) analysis and PCR-DNA sequencing. When a target region within the thymidine kinase (TK) gene was examined by HRM analysis, 6 out of the 11 isolates from abortion cases and 22 out of the 25 isolates from bovine respiratory disease (BRD) cases had different melting curves compared to the vaccine virus. Surprisingly, when a conserved region within the US6 gene that encodes glycoprotein D (gD) was examined by HRM analysis, 5 out of the 11 abortion isolates and 18 out of the 23 BRD isolates had different melting curves from the vaccine virus. To determine whether SNPs within the coding regions of glycoprotein E (gE) and TK genes can be used to differentiate the isolates from the vaccine virus, PCR-DNA sequencing was used to examine these SNPs in all the isolates. This revealed that only 1 out of 11 of the abortion isolates and 4 out of 24 of the BRD isolates are different in the target region of gE from the vaccine virus, while 5 out of 11 abortion isolates and 4 out of 22 BRD isolates are different in the target region of TK from the vaccine virus. No DNA sequence differences were observed in glycoprotein G (gG) region between disease and vaccine isolates. Our study demonstrated that many disease isolates had genetic differences from the vaccine virus in regions examined by HRM and PCR-DNA sequencing analysis. In addition, many isolates contained more than one type of mutation and were composed of mixed variants. Our study suggests that a mixture of variants were present in isolates collected post-vaccination. HRM is a rapid diagnostic method that can be used for

  8. Sexual orientation identity change and depressive symptoms: a longitudinal analysis.

    Science.gov (United States)

    Everett, Bethany

    2015-03-01

    Several new studies have documented high rates of sexual identity mobility among young adults, but little work has investigated the links between identity change and mental health. This study uses the National Longitudinal Study of Adolescent to Adult Health (N = 11,727) and employs multivariate regression and propensity score matching to investigate the impact of identity change on depressive symptoms. The results reveal that only changes in sexual identity toward more same-sex-oriented identities are associated with increases in depressive symptoms. Moreover, the negative impacts of identity change are concentrated among individuals who at baseline identified as heterosexual or had not reported same-sex romantic attraction or relationships. No differences in depressive symptoms by sexual orientation identity were found among respondents who reported stable identities. Future research should continue to investigate the factors that contribute to the relationship between identity change and depression, such as stigma surrounding sexual fluidity. © American Sociological Association 2015.

  9. Longitudinal analysis of midlife generativity, intergenerational roles, and caregiving.

    Science.gov (United States)

    Peterson, Bill E

    2002-03-01

    Items from the California Adult Q-Sort (CAQ) were used to assess psychosocial generativity (E. H. Erikson, 1950) in a sample of educated women at midlife. CAQ scores measured at age 43 demonstrated convergent validity with an inventory measure of generativity assessed at age 53. According to other longitudinal analyses, women who attained a generative stance at age 43 reported greater investment 10 years later in intergenerational roles (e.g., daughter, mother) but not nonintergenerational ones (e.g., friend, sister). Generative women also reported less subjective burden in caring for aging parents and more knowledge about community elder care programs. Further evidence suggests that participants felt embedded in a reciprocal caregiving network in which they themselves were the recipients of care.

  10. A Longitudinal Analysis of Search Engine Index Size

    DEFF Research Database (Denmark)

    Van den Bosch, Antal; Bogers, Toine; De Kunder, Maurice

    2015-01-01

    One of the determining factors of the quality of Web search engines is the size of their index. In addition to its influence on search result quality, the size of the indexed Web can also tell us something about which parts of the WWW are directly accessible to the everyday user. We propose a novel...... method of estimating the size of a Web search engine’s index by extrapolating from document frequencies of words observed in a large static corpus of Web pages. In addition, we provide a unique longitudinal perspective on the size of Google and Bing’s indexes over a nine-year period, from March 2006...... until January 2015. We find that index size estimates of these two search engines tend to vary dramatically over time, with Google generally possessing a larger index than Bing. This result raises doubts about the reliability of previous one-off estimates of the size of the indexed Web. We find...

  11. Sexual Orientation Identity Change and Depressive Symptoms: A Longitudinal Analysis

    Science.gov (United States)

    Everett, Bethany

    2015-01-01

    Several new studies have documented high rates of sexual identity mobility among young adults, but little work has investigated the links between identity change and mental health. This study uses the National Longitudinal Study of Adolescent to Adult Health (N = 11,727) and employs multivariate regression and propensity score matching to investigate the impact of identity change on depressive symptoms. The results reveal that only changes in sexual identity toward more same-sex-oriented identities are associated with increases in depressive symptoms. Moreover, the negative impacts of identity change are concentrated among individuals who at baseline identified as heterosexual or had not reported same-sex romantic attraction or relationships. No differences in depressive symptoms by sexual orientation identity were found among respondents who reported stable identities. Future research should continue to investigate the factors that contribute to the relationship between identity change and depression, such as stigma surrounding sexual fluidity. PMID:25690912

  12. An Assessment of Image Analysis of Longitudinal Bone Changes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin; Kim, Jae Duck [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1997-02-15

    This study was performed to assess the analyzing methods developed to detect clinically and quantitatively longitudinal bone changes. Through preliminary experiment, accuracy of Cu-Eq value conversion to the mass of HA was examined. For main experiment, 15 intraoral radiograms taken at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture in extracted sites of 3 cases were user. We took the radiograms with copper step wedge as test object and HA phantom. X -ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner into computer were digitized and analyzed by NH image program, the stability of the copper equivalent transformation and the usefulness of two analyzing methods by ROI and Reslice were examined. Obtained results as follows : 1. On the Cu equivalent images, the coefficient of variation in the measurement of Cu-Eq. value of ROI ranged from 0.05 to 0.24 and showed high reproducibility. 2. All results obtained by resliced contiguous images were coincident with those obtained from the assessment by ROI an d formation of plot profile. 3. On the stacked and resliced image at the line of interest, we could analyze directly and quantitatively the longitudinal changes at several portions by plot profile and qualitatively by surface plot. 4. Implant area showed marked resorption till 2 weeks after implantation and showed significant increase in Cu-Eq. value at 6th week (P<0.01) and periapical area showed increase in Cu-Eq. value at 6th week compared to after-operation's.

  13. FDTD analysis of dielectric-loaded longitudinally slotted rectangular waveguides.

    Science.gov (United States)

    Al-Rizzo, Hussain M; Younies, Hassan Z; Clark, Ken G; Tranquilla, Jim M

    2003-01-01

    A versatile electromagnetic (EM) computational algorithm, based on the Finite-Difference Time-Domain (FDTD) technique, is developed to analyze longitudinally oriented, square-ended, single slot fixtures and slot-pair configurations cut in the broad wall of a WR-975 guide operating at a frequency of 915 MHz. The finite conductivity of the waveguide walls is accounted for by employing a time-domain Surface-Impedance Boundary Conditions (SIBC) formulation. The proposed FDTD algorithm has been validated against measurements performed on a probe-excited slot cut along the center line of the broad wall of a WR-284 guide and available experimental data for energy coupled from a longitudinal slot pair in the broad wall of a WR-340 guide. Numerical results are-presented to exploit the influence of the constitutive parameters of the processed material as well as protective insulating window slabs mounted on the exterior surface of the slots. Particular attention is given to the resonant length, scattering parameters, and the electric field distribution within lossy objects placed in the near-field region over a range of slot offsets and workloads with extensive results being reported for the first time. It is shown that the FDTD technique can accurately predict the coupling and power absorption characteristics in loads located in the near field zone of the slotted waveguide structures and, therefore, should prove to be a powerful design tool applicable to a wide class of slotted waveguide applicators that may be difficult to analyze using other available techniques.

  14. Self-Concept and Academic Achievement: A Meta-Analysis of Longitudinal Relations

    Science.gov (United States)

    Huang, Chiungjung

    2011-01-01

    The relation between self-concept and academic achievement was examined in 39 independent and longitudinal samples through the integration of meta-analysis and path analysis procedures. For relations with more than 3 independent samples, the mean observed correlations ranged from 0.20 to 0.27 between prior self-concept and subsequent academic…

  15. [Adverse reaction caused by rabies vaccine in China: a Meta-analysis].

    Science.gov (United States)

    Zhang, X R; Wu, Z G; Zhang, W S

    2017-06-10

    Objective: To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine, so as to provide reference for rabies vaccine immunization in China. Methods: We electronically searched databases including CNKI, VIP information resource integration service platform, WanFang Data, CBM, PubMed and The Cochrane Library, to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions, from January 2000 to July 2016. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the adverse reaction rate was performed using the R software. Results: A total of 29 related papers had met the inclusion criteria, with no publication bias noticed. A total number of 11 020 cases had adverse reactions, among all the 94 222 respondents, with an incidence of adverse reactions as 1.04 % -47.78 % . The overall incidence rate of adverse reaction was 9.82 % (95 %CI : 7.58 % -12.72 % ). A combined local adverse reaction rate appeared as 12.05 % (95 % CI : 9.26 % -15.69 % ). The systemic adverse reaction rate was 9.06 % (95 %CI : 7.07 % -11.61 % ). The overall adverse reaction rate on aqueous vaccine was 32.39 % (95 %CI : 21.88 % -47.94 % ). Combined adverse reaction rate of freeze dried vaccine appeared as 8.65 % (95 %CI : 4.54 % -16.51 % ). Significant differences were seen between both groups ( P rabies vaccination was higher than the systemic adverse reaction rate. The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine. Our results suggested that the aqueous vaccine should gradually be eliminated.

  16. Probabilistic Cost-Effectiveness Analysis of Vaccination for Mild or Moderate Alzheimer's Disease.

    Science.gov (United States)

    Yang, Kuen-Cheh; Chen, Hsiu-Hsi

    2016-01-01

    Studies on the immunotherapy for Alzheimer's disease (AD) have increasingly gained attention since 1990s. However, there are pros (preventing of AD) and cons (incurred cost and side effects) regarding the administration of immunotherapy. Up to date, there has been lacking of economic evaluation for immunotherapy of AD. We aimed to assess the cost-effectiveness analysis of the vaccination for AD. A meta-analysis of randomized control trials after systemic review was conducted to evaluate the efficacy of the vaccine. A Markov decision model was constructed and applied to a 120,000-Taiwanese cohort aged ≥65 years. Person years and quality-adjusted life years (QALY) were computed between the vaccinated group and the the unvaccinated group. Economic evaluation was performed to calculate the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curve (CEAC). Vaccinated group gained an additional 0.84 life years and 0.56 QALYs over 10-years and an additional 0.35 life years and 0.282 QALYs over 5-years of follow-up. The vaccinated group dominated the unvaccinated group by ICER over 5-years of follow-up. The ICERs of 10-year follow-up for the vaccinated group against the unvaccinated group were $13,850 per QALY and $9,038 per life year gained. Given the threshold of $20,000 of willingness to pay (WTP), the CEAC showed the probability of being cost-effective for vaccination with QALY was 70.7% and 92% for life years gained after 10-years of follow-up. The corresponding figures were 87.3% for QALY and 93.5% for life years gained over 5-years follow-up. The vaccination for AD was cost-effective in gaining QALY and life years compared with no vaccination, under the condition of a reasonable threshold of WTP.

  17. A systematic review and meta-analysis on the safety of newly adjuvanted vaccines among children.

    Science.gov (United States)

    Stassijns, Jorgen; Bollaerts, Kaatje; Baay, Marc; Verstraeten, Thomas

    2016-02-03

    New adjuvants such as the AS- or the MF59-adjuvants improve vaccine efficacy and facilitate dose-sparing. Their use in influenza and malaria vaccines has resulted in a large body of evidence on their clinical safety in children. We carried out a systematic search for safety data from published clinical trials on newly adjuvanted vaccines in children ≤10 years of age. Serious adverse events (SAEs), solicited AEs, unsolicited AEs and AEs of special interest were evaluated for four new adjuvants: the immuno-stimulants containing adjuvant systems AS01 and AS02, and the squalene containing oil-in-water emulsions AS03 and MF59. Relative risks (RR) were calculated, comparing children receiving newly adjuvanted vaccines to children receiving other vaccines with a variety of antigens, both adjuvanted and unadjuvanted. Twenty-nine trials were included in the meta-analysis, encompassing 25,056 children who received at least one dose of the newly adjuvanted vaccines. SAEs did not occur more frequently in adjuvanted groups (RR 0.85, 95%CI 0.75-0.96). Our meta-analyses showed higher reactogenicity following administration of newly adjuvanted vaccines, however, no consistent pattern of solicited AEs was observed across adjuvant systems. Pain was the most prevalent AE, but often mild and of short duration. No increased risks were found for unsolicited AEs, febrile convulsions, potential immune mediated diseases and new onset of chronic diseases. Our meta-analysis did not show any safety concerns in clinical trials of the newly adjuvanted vaccines in children ≤10 years of age. An unexplained increase of meningitis in one Phase III AS01-adjuvanted malaria trial and the link between narcolepsy and the AS03-adjuvanted pandemic vaccine illustrate that continued safety monitoring is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Economic studies applied to vaccines against invasive diseases: An updated budget impact analysis of age-based pneumococcal vaccination strategies in the elderly in Italy.

    Science.gov (United States)

    Boccalini, Sara; Bechini, Angela; Gasparini, Roberto; Panatto, Donatella; Amicizia, Daniela; Bonanni, Paolo

    2017-02-01

    Many evaluations have been performed on the economic impact of pneumococcal vaccination in older adults (>64 y of age) in several countries, including Italy. However, these studies did not include the new data on the effectiveness of 13-valent conjugate pneumococcal vaccine (PCV13) in the elderly reported by the CAPiTA Study. The aim of the present study was to update our previous budget impact analysis of multi-cohort PCV13 vaccination in adults in Italy by including new scientific evidence. We also compared single-cohort vaccination strategies per year, in order to identify the cohort with the most favorable economic profile, in the event of the multi-cohort approach not being economically sustainable for the National Health System (NHS). The new impact analysis highlights that the vaccination of one, two or three adult cohorts per year in Italy would lead to a considerable reduction in pneumococcal disease and its related costs over 5 y. The strategies proved cost-effective (ICERs ranging from €14,605 to €15,412/QALY), i.e. well below the threshold of €50,000/QALY. The ICERs were slightly lower than those calculated in the first published analysis and vaccination continued to be economically favorable. In the case of a mono-cohort strategy, the vaccination of 65-year-old subjects, albeit more expensive, proved to be more favorable than the vaccination of 70- or 75-year-old cohorts. Finally, after the inclusion of the recent clinical evidence, the age-based PCV13 vaccination of the elderly in Italy continued to be economically justified from the NHS perspective in the short period. Vaccination of the elderly should therefore be strongly recommended nationwide in Italy.

  19. Ontology-based Brucella vaccine literature indexing and systematic analysis of gene-vaccine association network

    OpenAIRE

    Xiang Zuoshuang; Hur Junguk; Feldman Eva L; He Yongqun

    2011-01-01

    Abstract Background Vaccine literature indexing is poorly performed in PubMed due to limited hierarchy of Medical Subject Headings (MeSH) annotation in the vaccine field. Vaccine Ontology (VO) is a community-based biomedical ontology that represents various vaccines and their relations. SciMiner is an in-house literature mining system that supports literature indexing and gene name tagging. We hypothesize that application of VO in SciMiner will aid vaccine literature indexing and mining of va...

  20. A fuzzy MICMAC analysis for improving supply chain performance of basic vaccines in developing countries.

    Science.gov (United States)

    Chandra, Dheeraj; Kumar, Dinesh

    2018-03-01

    In recent years, demand to improve child immunization coverage globally, and the development of the latest vaccines and technology has made the vaccine market very complex. The rise in such complexities often gives birth to numerous issues in the vaccine supply chain, which are the primary cause of its poor performance. Figuring out the cause of the performance problem can help you decide how to address it. The goal of the present study is to identify and analyze important issues in the supply chain of basic vaccines required for child immunization in the developing countries. Twenty-five key issues as various factors of the vaccine supply chain have been presented in this paper. Fuzzy MICMAC analysis has been carried out to classify the factors based on their driving and dependence power and to develop a hierarchy based model. Further, the findings have been discussed with the field experts to identify the critical factors. Three factors: better demand forecast, communication between the supply chain members, and proper planning and scheduling have been identified as the critical factors of vaccine supply chain. These factors should be given special care to improve vaccine supply chain performance.

  1. Genetic characterization of Chinese measles vaccines by analysis of complete genomic sequences.

    Science.gov (United States)

    Zhang, Yan; Zhou, Jianhui; Bellini, William J; Xu, Wenbo; Rota, Paul A

    2009-08-01

    The complete genomic sequences of two Chinese measles vaccine viruses, Shanghai-191 (S-191) and Changchun-47 (C-47), were determined and compared to the sequences of other measles vaccine strains as well as the prototype measles strain, Edmonston wild-type (Edwt). Compared to Edwt, S-191 and C-47 had 49 and 43 nucleotide changes, respectively. These differences were found at 52 nucleotide positions that were not found in other vaccine strains. Phylogenetic analysis of the all of the available genomic sequences for measles vaccines showed that S-191 and C-47 were most closely related to the Leningrad-4 strain. S-191 and C-47 shared conserved vaccine virus-specific amino acid changes in the phosphoprotein (P), V, C, matrix (M), and hemagglutinin (H) that could represent important targets for future studies aimed at understanding the molecular basis of attenuation. In addition, S-191 and C-47 had several unique amino acid changes including 13 positions that differed from Edwt. This is the first comparison of the complete genomic sequences of Chinese measles vaccines to the sequences of other vaccine strains. 2009 Wiley-Liss, Inc.

  2. Response of transplant recipients to influenza vaccination based on type of immunosuppression: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Reza Karbasi-Afshar

    2015-01-01

    Full Text Available Influenza vaccination is widely used in transplant recipients, but there is little known about the significance and correlating factors of its effectiveness. In the current study, we reviewed the existing literature on clinical trials performed in transplant recipients on the effectiveness of influenza vaccination and to evaluate the relevance of the type of immunosuppression employed in these patients on the humoral reaction to the vaccine. A comprehensive search of the literature was performed through Pubmed and Google Scholar to find reports indicating immunogenicity of influenza vaccination in transplant patients. Finally, data from 15 published clinical trials were included in the meta-analysis. Data of 947 transplant recipients retrieved from 15 clinical trials investigating the immunogenicity of influenza vaccination were analyzed in this meta-analysis. Analysis showed significantly lower rates of sero-conversion among transplant recipients receiving mycophenolate mofetil (MMF than other immunosuppressive agents (relative risk: 0.724; 95% confidence interval: 0.596-0.880; P = 0.001. No significant correlation was found with tacrolimus, sirolimus, cyclosporine and azathioprine. Different immunosuppressive agents seem to have different effects on the humoral response rate to influenza vaccination, with MMF having the most significant deleterious effect. The limited and controversial data available in the literature do not support any differential effect for other immunosuppressive agents.

  3. Ontology-based combinatorial comparative analysis of adverse events associated with killed and live influenza vaccines.

    Directory of Open Access Journals (Sweden)

    Sirarat Sarntivijai

    Full Text Available Vaccine adverse events (VAEs are adverse bodily changes occurring after vaccination. Understanding the adverse event (AE profiles is a crucial step to identify serious AEs. Two different types of seasonal influenza vaccines have been used on the market: trivalent (killed inactivated influenza vaccine (TIV and trivalent live attenuated influenza vaccine (LAIV. Different adverse event profiles induced by these two groups of seasonal influenza vaccines were studied based on the data drawn from the CDC Vaccine Adverse Event Report System (VAERS. Extracted from VAERS were 37,621 AE reports for four TIVs (Afluria, Fluarix, Fluvirin, and Fluzone and 3,707 AE reports for the only LAIV (FluMist. The AE report data were analyzed by a novel combinatorial, ontology-based detection of AE method (CODAE. CODAE detects AEs using Proportional Reporting Ratio (PRR, Chi-square significance test, and base level filtration, and groups identified AEs by ontology-based hierarchical classification. In total, 48 TIV-enriched and 68 LAIV-enriched AEs were identified (PRR>2, Chi-square score >4, and the number of cases >0.2% of total reports. These AE terms were classified using the Ontology of Adverse Events (OAE, MedDRA, and SNOMED-CT. The OAE method provided better classification results than the two other methods. Thirteen out of 48 TIV-enriched AEs were related to neurological and muscular processing such as paralysis, movement disorders, and muscular weakness. In contrast, 15 out of 68 LAIV-enriched AEs were associated with inflammatory response and respiratory system disorders. There were evidences of two severe adverse events (Guillain-Barre Syndrome and paralysis present in TIV. Although these severe adverse events were at low incidence rate, they were found to be more significantly enriched in TIV-vaccinated patients than LAIV-vaccinated patients. Therefore, our novel combinatorial bioinformatics analysis discovered that LAIV had lower chance of inducing these

  4. Intraoperative mapping of language functions: a longitudinal neurolinguistic analysis.

    Science.gov (United States)

    Ilmberger, Josef; Ruge, Maximilian; Kreth, Friedrich-Wilhelm; Briegel, Josef; Reulen, Hans-Juergen; Tonn, Joerg-Christian

    2008-10-01

    This prospective longitudinally designed study was conducted to evaluate language functions pre- and postoperatively in patients who underwent microsurgical treatment of tumors in close proximity to or within language areas and to detect those patients at risk for a postoperative aphasic disturbance. Between 1991 and 2005, 153 awake craniotomies with subsequent cortical mapping of language functions were performed in 149 patients. Language functions were assessed using a standardized test battery. Risk factors were obtained from multivariate logistic regression models. Language mapping was able to be performed in all patients, and complete tumor resection was achieved in 48.4%. Within 21 days after surgery a new language deficit (aphasic disturbance) was observed in 41 (32%) of the 128 cases without preoperative deficits. There were a total of 60 cases involving postoperative aphasic disturbances, including cases both with and without preoperative disturbances. Risk factors for postoperative aphasic disturbance were preoperative aphasia (p40 years, p<0.02) and preoperative aphasia (p<0.001). Every attempt should be undertaken to preserve language-relevant areas intraoperatively, even when they are located within the tumor. New postoperative deficits resolve in the majority of patients, which may be a result of cortical mapping as well as functional reorganization.

  5. Predicting adolescent's cyberbullying behavior: A longitudinal risk analysis.

    Science.gov (United States)

    Barlett, Christopher P

    2015-06-01

    The current study used the risk factor approach to test the unique and combined influence of several possible risk factors for cyberbullying attitudes and behavior using a four-wave longitudinal design with an adolescent US sample. Participants (N = 96; average age = 15.50 years) completed measures of cyberbullying attitudes, perceptions of anonymity, cyberbullying behavior, and demographics four times throughout the academic school year. Several logistic regression equations were used to test the contribution of these possible risk factors. Results showed that (a) cyberbullying attitudes and previous cyberbullying behavior were important unique risk factors for later cyberbullying behavior, (b) anonymity and previous cyberbullying behavior were valid risk factors for later cyberbullying attitudes, and (c) the likelihood of engaging in later cyberbullying behavior increased with the addition of risk factors. Overall, results show the unique and combined influence of such risk factors for predicting later cyberbullying behavior. Results are discussed in terms of theory. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  6. A longitudinal analysis of cigarette prices in military retail outlets.

    Science.gov (United States)

    Haddock, Christopher Keith; Hyder, Melissa L; Poston, Walker S C; Jahnke, Sara A; Williams, Larry N; Lando, Harry

    2014-04-01

    We conducted a longitudinal assessment of tobacco pricing in military retail outlets, including trends within each service branch. We determined the price of a single pack of Marlboro Red cigarettes at military retail stores located in the continental United States, Alaska, and Hawaii and at their nearest Walmarts in spring 2011 and 2013 (n = 128 for pairs available at both assessments). The average difference between cigarettes sold in military retail outlets and Walmarts decreased from 24.5% in 2011 to 12.5% in 2013. The decrease was partially attributable to significant price decreases at Walmarts. The largest increases in cigarette prices occurred on naval installations. Potential savings at stores on several installations remained substantial in 2013; the largest approached $6 per pack. Stores on 17 military installations decreased cigarette prices during the study period. Tobacco can be purchased in military retail stores at substantial savings over civilian stores. If tobacco pricing is to cease to be an incentive for use among personnel, a revised military tobacco pricing policy is needed.

  7. Analysis of public concerns about influenza vaccinations by mining a massive online question dataset in Japan.

    Science.gov (United States)

    Nawa, Nobutoshi; Kogaki, Shigetoyo; Takahashi, Kunihiko; Ishida, Hidekazu; Baden, Hiroki; Katsuragi, Shinichi; Narita, Jun; Tanaka-Taya, Keiko; Ozono, Keiichi

    2016-06-08

    Elucidating public concerns regarding vaccinations is important for successful immunization programs. The objective of the present study was to categorize public concerns regarding influenza vaccinations in Japan by analyzing a massive web-based question dataset. The Yahoo! Chiebukuro (Japanese Yahoo! Answers) Dataset, which includes more than 16 million questions collected between April 2004 and April 2009, was used in this study. We sequentially filtered data to obtain questions on influenza vaccinations. Any questions that met our exclusion criteria concerning veterinary vaccines or computer virus vaccines were removed from the analysis. Filtered questions and their answers were manually analyzed for their content by a team of board-certified pediatricians. After filtering data, we obtained 1950 questions regarding influenza vaccinations. The three most frequently asked questions were regarding the vaccination schedule, safety, and effectiveness. When we analyzed monthly trends in question contents, we noted the emergence of similar questions in the same period every year. Therefore, we classified the time periods of each year into three parts: (1) from April to the commencement of seasonal influenza vaccinations (September), (2) from October until the epidemic period, and (3) the epidemic period. Two interesting results were obtained: concerns regarding effectiveness abruptly increased during the epidemic period, and pregnant or breastfeeding women increasingly asked questions regarding feasibility between October and the epidemic period. The questions and concerns collected and analyzed in this study illustrate that the public have questions about the influenza vaccine and also that questions changed with periodical consistency. These results highlight the possible usefulness of providing the public with the latest and correct information to their questions in a timely manner, for example via an official health website. Copyright © 2016 Elsevier Ltd. All

  8. Accelerating policy decisions to adopt haemophilus influenzae type B vaccine: a global, multivariable analysis.

    Directory of Open Access Journals (Sweden)

    Jessica C Shearer

    2010-03-01

    Full Text Available Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance.Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18-0.76, or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33-0.75. For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00-1.04. Global recommendations and local studies were not associated with time to decision.This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors.

  9. Accelerating Policy Decisions to Adopt Haemophilus influenzae Type b Vaccine: A Global, Multivariable Analysis

    Science.gov (United States)

    Shearer, Jessica C.; Stack, Meghan L.; Richmond, Marcie R.; Bear, Allyson P.; Hajjeh, Rana A.; Bishai, David M.

    2010-01-01

    Background Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance). Methods and Findings Data for 147 countries from 1990 to 2007 were analyzed in accelerated failure time models to identify factors that are associated with the time to decision to adopt Hib vaccine. In multivariable models that control for Gross National Income, region, and burden of Hib disease, the receipt of GAVI support speeded the time to decision by a factor of 0.37 (95% CI 0.18–0.76), or 63%. The presence of two or more neighboring country adopters accelerated decisions to adopt by a factor of 0.50 (95% CI 0.33–0.75). For each 1% increase in vaccine price, decisions to adopt are delayed by a factor of 1.02 (95% CI 1.00–1.04). Global recommendations and local studies were not associated with time to decision. Conclusions This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors. Please see later in the article for the Editors' Summary PMID:20305714

  10. Intervention analysis of introduction of rotavirus vaccine on hospital admissions rates due to acute diarrhea

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Teixeira Masukawa

    2014-10-01

    Full Text Available The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.

  11. aBEAT: a toolbox for consistent analysis of longitudinal adult brain MRI.

    Directory of Open Access Journals (Sweden)

    Yakang Dai

    Full Text Available Longitudinal brain image analysis is critical for revealing subtle but complex structural and functional changes of brain during aging or in neurodevelopmental disease. However, even with the rapid increase of clinical research and trials, a software toolbox dedicated for longitudinal image analysis is still lacking publicly. To cater for this increasing need, we have developed a dedicated 4D Adult Brain Extraction and Analysis Toolbox (aBEAT to provide robust and accurate analysis of the longitudinal adult brain MR images. Specially, a group of image processing tools were integrated into aBEAT, including 4D brain extraction, 4D tissue segmentation, and 4D brain labeling. First, a 4D deformable-surface-based brain extraction algorithm, which can deform serial brain surfaces simultaneously under temporal smoothness constraint, was developed for consistent brain extraction. Second, a level-sets-based 4D tissue segmentation algorithm that incorporates local intensity distribution, spatial cortical-thickness constraint, and temporal cortical-thickness consistency was also included in aBEAT for consistent brain tissue segmentation. Third, a longitudinal groupwise image registration framework was further integrated into aBEAT for consistent ROI labeling by simultaneously warping a pre-labeled brain atlas to the longitudinal brain images. The performance of aBEAT has been extensively evaluated on a large number of longitudinal MR T1 images which include normal and dementia subjects, achieving very promising results. A Linux-based standalone package of aBEAT is now freely available at http://www.nitrc.org/projects/abeat.

  12. aBEAT: a toolbox for consistent analysis of longitudinal adult brain MRI.

    Science.gov (United States)

    Dai, Yakang; Wang, Yaping; Wang, Li; Wu, Guorong; Shi, Feng; Shen, Dinggang

    2013-01-01

    Longitudinal brain image analysis is critical for revealing subtle but complex structural and functional changes of brain during aging or in neurodevelopmental disease. However, even with the rapid increase of clinical research and trials, a software toolbox dedicated for longitudinal image analysis is still lacking publicly. To cater for this increasing need, we have developed a dedicated 4D Adult Brain Extraction and Analysis Toolbox (aBEAT) to provide robust and accurate analysis of the longitudinal adult brain MR images. Specially, a group of image processing tools were integrated into aBEAT, including 4D brain extraction, 4D tissue segmentation, and 4D brain labeling. First, a 4D deformable-surface-based brain extraction algorithm, which can deform serial brain surfaces simultaneously under temporal smoothness constraint, was developed for consistent brain extraction. Second, a level-sets-based 4D tissue segmentation algorithm that incorporates local intensity distribution, spatial cortical-thickness constraint, and temporal cortical-thickness consistency was also included in aBEAT for consistent brain tissue segmentation. Third, a longitudinal groupwise image registration framework was further integrated into aBEAT for consistent ROI labeling by simultaneously warping a pre-labeled brain atlas to the longitudinal brain images. The performance of aBEAT has been extensively evaluated on a large number of longitudinal MR T1 images which include normal and dementia subjects, achieving very promising results. A Linux-based standalone package of aBEAT is now freely available at http://www.nitrc.org/projects/abeat.

  13. Systemic inflammation and lung function: A longitudinal analysis.

    Science.gov (United States)

    Hancox, Robert J; Gray, Andrew R; Sears, Malcolm R; Poulton, Richie

    2016-02-01

    Systemic inflammation is associated with impaired lung function in healthy adults as well as in patients with lung disease. The mechanism for this association is unknown and it is unclear if systemic inflammation leads to impaired lung function or if poor lung function leads to inflammation. We explored the temporal associations between blood C-reactive protein (CRP), fibrinogen, and white blood cells, and lung function in young adults. Spirometry, plethysmography, and diffusion capacity were measured in a population-based cohort at ages 32 and 38 years. High-sensitivity CRP, fibrinogen, and white blood cells were measured at the same ages. Higher levels of CRP and, to a lesser extent, fibrinogen were associated with lower lung volumes in cross-sectional analyses at both ages 32 and 38 years. Higher CRP and fibrinogen at age 32 were associated with higher FEV1 and FEV1/FVC at age 38, but not other measures of lung function. Lower lung volumes (total lung capacity, functional residual capacity, and residual volume) but not airflow obstruction (FEV1/FVC) at age 32 were associated with higher CRP at age 38. Associations between age 32 lung function and fibrinogen at follow-up were weaker, but consistent. There were no longitudinal associations between white blood cells and lung function. We found no evidence that systemic inflammation causes a decline in lung function. However, lower lung volumes were associated with higher CRP and fibrinogen at follow-up indicating that pulmonary restriction may be a risk factor for systemic inflammation. The mechanism for this association remains unclear. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Cost-effectiveness analysis of rotavirus vaccination among Libyan ...

    African Journals Online (AJOL)

    The objective of this study is to evaluate the cost-effectiveness of rotavirus vaccination in that country. Methods: We used a published decision tree model that has been adapted to the Libyan situation to analyze a birth cohort of 160,000 children. The evaluation of diarrhea events in three public hospitals helped to estimate ...

  15. Genotypic characterization by multi locus variable number of tandem repeats analysis international Bordetella pertussis vaccine strains

    Directory of Open Access Journals (Sweden)

    M. Fatah Moghadam

    2017-10-01

    Full Text Available Background: In 1930's first whole cell pertussis vaccines became available to the public heralding a dramatic success in overcoming the global burden of the disease. To date only a handful of B. pertussis strains have been used by international/local pertussis vaccine manufacturers. Inevitable well-documented genetic changes in the world population of this pathogen have prompted serious questions on suitability of traditional vaccine strains protect human against currently circulating wild isolates of Bordetella pertussis. Objective: Analyzing the genetic diversity within the most frequently-used vaccine strains of B. pertussis in the world Methods: A recently developed multi locus variable number of tandem repeats analysis (MLVA genotyping system along with a bioinforamtic piece of analysis was conducted on 11 strain / substrains of B137, B203 (10536, C393, Cs, E476, Tohama I, J445 (134, B202 and J446 (509 plus 2 sub-strains of 134 and 509 that are used at Razi institute for preparation of pertussis vaccine. In this study have used 6 individual loci of VNTR1, VNTR3a, VNTR3b, VNTR4, VNTR5 and VNTR6. Findings: Six distinct genotypes were recognized among the examined strains by comparing our data with the Dutch MLVA databank. These were all new and not reported before in the database. Conclusion: This observation reiterates on necessity for detection of predominant native strains to include in vaccine preparations suitable for different countries.

  16. Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis.

    Science.gov (United States)

    Shearer, Freya M; Moyes, Catherine L; Pigott, David M; Brady, Oliver J; Marinho, Fatima; Deshpande, Aniruddha; Longbottom, Joshua; Browne, Annie J; Kraemer, Moritz U G; O'Reilly, Kathleen M; Hombach, Joachim; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S; Hay, Simon I; Golding, Nick; Reiner, Robert C

    2017-11-01

    Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. The Rhodes Trust, Bill & Melinda Gates Foundation, the

  17. Characteristics of Articles About Human Papillomavirus Vaccination in Japanese Newspapers: Time-Series Analysis Study.

    Science.gov (United States)

    Ueda, Nao; Yokouchi, Ryoki; Onoda, Taro; Ogihara, Atsushi

    2017-12-19

    Media coverage and reports have a major influence on individual vaccination and other health-related activities. People use the media to seek information and knowledge on health-related behaviors. They obtain health-related information from media such as television and newspapers, and they trust such information. While several studies have examined the relation between media coverage and individual health, there is a lack of studies that have analyzed media reports of health information. In particular, we have found no analyses related to cervical cancer (human papillomavirus [HPV]) vaccine. This study aimed to identify mentions of cervical cancer vaccine in Japan's printed news media and to determine their characteristics. We used the archival databases of 2 Japanese newspapers, Yomiuri Shimbun (Yomidasu Rekishikan) and Asahi Shimbun (Kikuzo II Visual), for text mining. First, we created a database by extracting articles published between January 1, 2007, and December 31, 2014, that matched the terms "cervical cancer" AND "vaccination" in a keyword search. Then, we tallied the extracted articles based on the month of publication and number of characters in order to conduct a time-series analysis. We extracted a total of 219 articles. Of these, 154 (70.3%) were positive and 51 (23.3%) were negative toward HPV vaccination. Of the 51 negative articles, 4 (7.8%) were published before June 2013, when routine vaccination was temporarily discontinued due to concerns regarding side effects, and 47 (92.2%) were published since then. The negative reports commonly cited side effects, although prior to June 2013, these issues were hardly mentioned. Although foreign media reports mentioned side effects before routine vaccination was temporarily discontinued, fewer articles mentioned side effects than recommendations for vaccination. Furthermore, on June 13, 2013, the World Health Organization's advisory body Global Advisory Committee on Vaccine Safety issued a statement

  18. Cost-effectiveness analysis of quadrivalent vaccine for prevention of cervical cancer in Serbia

    Directory of Open Access Journals (Sweden)

    Stojić Isidora

    2012-01-01

    Full Text Available Cervical cancer is second the most common cancer and the fourth cancer in relation to of mortality in women. As many as 85% of reported cases are found in developing countries, such as Serbia. The incidence of cervical cancer in Serbia is 24.3/100,000 women/year, and Serbia is among the countries with very high risk of cervical cancer. This study aims to show cost/effectiveness of quadrivalent vaccine for the prevention of cervical cancer in Serbia. Analysis was conducted using TreeAge software and Markov model was based on the literature data about effectiveness and on local Serbian cost calculation. The duration of one cycle was one year and the time horizon was set to 60 cycles i.e. 60 years. Monte Carlo simulation was done with 1000 virtual patients and sensitivity analysis (incoming variables varied ±50% was presented by Tornado diagram. Application of quadrivalent vaccine for the prevention of cervical cancer proved to be very cost/effective method. This method was costeffective because costs were less than in the group that did not receive vaccine, and clinical efficacy in the vaccine group was slightly higher. After varying the incoming data for ±50%, the model remained stable, i.e. vaccine was still highly cost/effective. This study showed that use of vaccine for prevention of cervical cancer was very cost/effective. However, since the vaccine was recently marketed, and studies investigating its effectiveness longer than 5 years were not conducted, further studies are necessary to resolve question of long-term vaccine efficacy.

  19. A Content Analysis of Newspaper Coverage of the Seasonal Flu Vaccine in Ontario, Canada, October 2001 to March 2011.

    Science.gov (United States)

    Meyer, Samantha B; Lu, Stephanie K; Hoffman-Goetz, Laurie; Smale, Bryan; MacDougall, Heather; Pearce, Alex R

    2016-10-01

    Seasonal flu vaccine uptake has fallen dramatically over the past decade in Ontario, Canada, despite promotional efforts by public health officials. Media can be particularly influential in shaping the public response to seasonal flu vaccine campaigns. We therefore sought to identify the nature of the relationship between risk messages about getting the seasonal flu vaccine in newspaper coverage and the uptake of the vaccine by Ontarians between 2001 and 2010. A content analysis was conducted to quantify risk messages in newspaper content for each year of analysis. The quantification allowed us to test the correlation between the frequency of risk messages and vaccination rates. During the time period 2001-2010, vaccination rates were positively and significantly related to the frequency of risk messages in newspaper coverage (r = .691, p vaccine being ineffective, the flu vaccine being poorly understood by science, and the flu vaccine causing harm. Newspaper coverage plays an important role in shaping public response to seasonal flu vaccine campaigns. Public health officials should work alongside media to ensure that the public are exposed to information necessary for making informed decisions regarding vaccination.

  20. A cost-utility analysis of cervical cancer screening and human papillomavirus vaccination in the Philippines.

    Science.gov (United States)

    Guerrero, Anna Melissa; Genuino, Anne Julienne; Santillan, Melanie; Praditsitthikorn, Naiyana; Chantarastapornchit, Varit; Teerawattananon, Yot; Alejandria, Marissa; Toral, Jean Anne

    2015-07-30

    Cervical cancer is the second leading cause of cancer cases and deaths among Filipino women because of inadequate access to screening and treatment services. This study aims to evaluate the health and economic benefits of HPV vaccination and its combination with different screening strategies to find the most optimal preventive strategy in the Philippines. A cost-utility analysis was conducted using an existing semi-Markov model to evaluate different screening (i.e., Pap smear, visual inspection with acetic acid) and vaccination strategies against HPV infection implemented alone or as part of a combination strategy at different coverage scenarios. The model was run using country-specific epidemiologic, cost and clinical parameters from a health system perspective. Sensitivity analysis was performed for vaccine efficacy, duration of protection and costs of vaccination, screening and treatment. Across all coverage scenarios, VIA has been shown to be a dominant and cost-saving screening strategy with incremental cost-effectiveness ratio (ICER) ranging from dominant to Php 61,059 (1443 USD) per QALY gained. VIA can reduce cervical cancer cases and deaths by 25%. Pap smear screening was found to be not cost-effective due to its high cost in the Philippines. Adding HPV vaccination at a cost of 54 USD per vaccinated girl on top of VIA screening was found to be potentially cost-effective using a threshold of 1 GDP per capita (i.e., Php 120,000 or 2835 USD/ QALY) with the most favorable assumption of providing lifelong immunity against high-risk oncogenic HPV types 16/18. The highest incremental QALY gain was achieved with 80% coverage of the combined strategy of VIA at 35 to 45 years old done every five years following vaccination at 11 years of age with an ICER of Php 33,126 (783 USD). This strategy may result in a two-thirds reduction in cervical cancer burden. HPV vaccination is not cost-effective when vaccine protection lasts for less than 20 years. High VIA coverage

  1. Friendship Quality and School Achievement: A Longitudinal Analysis during Primary School

    Science.gov (United States)

    Zucchetti, Giulia; Candela, Filippo; Sacconi, Beatrice; Rabaglietti, Emanuela

    2015-01-01

    This study examined the longitudinal relationship between friendship quality (positive and negative) and school achievement among 228 school-age children (51% girls, M = 8.09, SD = 0.41). A three-wave cross-lagged analysis was used to determine the direction of influence between these domains across school years. Findings revealed that: (a) school…

  2. Statistical analysis of longitudinal quality of life data with missing measurements

    NARCIS (Netherlands)

    Zwinderman, A. H.

    1992-01-01

    The statistical analysis of longitudinal quality of life data in the presence of missing data is discussed. In cancer trials missing data are generated due to the fact that patients die, drop out, or are censored. These missing data are problematic in the monitoring of the quality of life during the

  3. Automated longitudinal intra-subject analysis (ALISA) for diffusion MRI tractography

    DEFF Research Database (Denmark)

    Aarnink, Saskia H; Vos, Sjoerd B; Leemans, Alexander

    2014-01-01

    the inter-subject and intra-subject automation in this situation are intended for subjects without gross pathology. In this work, we propose such an automated longitudinal intra-subject analysis (dubbed ALISA) approach, and assessed whether ALISA could preserve the same level of reliability as obtained...

  4. Evolution of Online Discussion Forum Richness according to Channel Expansion Theory: A Longitudinal Panel Data Analysis

    Science.gov (United States)

    Fernandez, Vicenc; Simo, Pep; Sallan, Jose M.; Enache, Mihaela

    2013-01-01

    The selection and use of communication media has been the center of attention for a great number of researchers in the area of organizational communication. The channel expansion theory combines elements of the main theories in this area; however, these investigations have a static cross-sectional design rather than a longitudinal analysis. With…

  5. Longitudinal Analysis of Somatic Cell Count for Joint Genetic Evaluation of Mastitis and Recovery Liability

    DEFF Research Database (Denmark)

    Welderufael, Berihu Gebremedhin; de Koning, D J; Janss, Luc

    Abstract Text: Better models of genetic evaluation for mastitis can be developed through longitudinal analysis of somatic cell count (SCC) which usually is used as a proxy for mastitis. Mastitis and recovery data with weekly observations of SCC were simulated for daughter groups of 60 and 240 per...

  6. Three Decades of Social Psychology: A Longitudinal Analysis of Baron and Byrne's Textbook

    Science.gov (United States)

    Christopher, Andrew N.; Marek, Pam; Dobbins, Emily M.; Jason R., Jason R.

    2004-01-01

    We analyzed the first 10 editions of Baron and Byrne's social psychology textbook. Modeling our methodology on Griggs and Jackson's (1996) longitudinal analysis of Hilgard's (1953) introductory psychology text, we ascertained changes in objective features, content, and contributors and contributions to social psychology. Changes in objective…

  7. Stability of peer victimization: A meta-analysis of longitudinal research

    NARCIS (Netherlands)

    Pouwels, J.L.; Souren, P.M.; Lansu, T.A.M.; Cillessen, A.H.N.

    2016-01-01

    A meta-analysis was conducted of 77 longitudinal studies that contained at least one over-time correlation (range 1 to 36) between scores for peer victimization measured at different time points. The overall stability of self-reported peer victimization was determined at centered values (age 10,

  8. Social Capital, Self-Esteem, and Use of Online Social Network Sites: A Longitudinal Analysis

    Science.gov (United States)

    Steinfield, Charles; Ellison, Nicole B.; Lampe, Cliff

    2008-01-01

    A longitudinal analysis of panel data from users of a popular online social network site, Facebook, investigated the relationship between intensity of Facebook use, measures of psychological well-being, and bridging social capital. Two surveys conducted a year apart at a large U.S. university, complemented with in-depth interviews with 18 Facebook…

  9. Profiles of Intrinsic and Extrinsic Motivations in Elementary School: A Longitudinal Analysis

    Science.gov (United States)

    Corpus, Jennifer Henderlong; Wormington, Stephanie V.

    2014-01-01

    The authors used a person-centered, longitudinal approach to identify and evaluate naturally occurring combinations of intrinsic and extrinsic motivations among 490 third- through fifth-grade students. Cluster analysis revealed 3 groups, characterized by high levels of both motivations ("high quantity"): high intrinsic motivation but low…

  10. Illegal Migration from Mexico to the United States: A Longitudinal Analysis

    Science.gov (United States)

    Frisbie, Parker

    1975-01-01

    A longitudinal analysis encompassing the period 1946 through 1965, relates the changes in migration rates of illegal migrants from Mexico to the United States to changes in certain predictor variables (farm wages and agricultural productivity in both the U.S. and Mexico, agricultural commodity prices in Mexico, and rate of capital investment in…

  11. Comprehensive sieve analysis of breakthrough HIV-1 sequences in the RV144 vaccine efficacy trial.

    Directory of Open Access Journals (Sweden)

    Paul T Edlefsen

    2015-02-01

    Full Text Available The RV144 clinical trial showed the partial efficacy of a vaccine regimen with an estimated vaccine efficacy (VE of 31% for protecting low-risk Thai volunteers against acquisition of HIV-1. The impact of vaccine-induced immune responses can be investigated through sieve analysis of HIV-1 breakthrough infections (infected vaccine and placebo recipients. A V1/V2-targeted comparison of the genomes of HIV-1 breakthrough viruses identified two V2 amino acid sites that differed between the vaccine and placebo groups. Here we extended the V1/V2 analysis to the entire HIV-1 genome using an array of methods based on individual sites, k-mers and genes/proteins. We identified 56 amino acid sites or "signatures" and 119 k-mers that differed between the vaccine and placebo groups. Of those, 19 sites and 38 k-mers were located in the regions comprising the RV144 vaccine (Env-gp120, Gag, and Pro. The nine signature sites in Env-gp120 were significantly enriched for known antibody-associated sites (p = 0.0021. In particular, site 317 in the third variable loop (V3 overlapped with a hotspot of antibody recognition, and sites 369 and 424 were linked to CD4 binding site neutralization. The identified signature sites significantly covaried with other sites across the genome (mean = 32.1 more than did non-signature sites (mean = 0.9 (p < 0.0001, suggesting functional and/or structural relevance of the signature sites. Since signature sites were not preferentially restricted to the vaccine immunogens and because most of the associations were insignificant following correction for multiple testing, we predict that few of the genetic differences are strongly linked to the RV144 vaccine-induced immune pressure. In addition to presenting results of the first complete-genome analysis of the breakthrough infections in the RV144 trial, this work describes a set of statistical methods and tools applicable to analysis of breakthrough infection genomes in general vaccine

  12. Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis.

    Science.gov (United States)

    Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard

    2013-10-01

    An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Cost-effectiveness analysis of the introduction of rotavirus vaccine in Iran.

    Science.gov (United States)

    Javanbakht, Mehdi; Moradi-Lakeh, Maziar; Yaghoubi, Mohsen; Esteghamati, Abdoulreza; Mansour Ghanaie, Roxana; Mahmoudi, Sussan; Shamshiri, Ahmad-Reza; Zahraei, Seyed Mohsen; Baxter, Louise; Shakerian, Sareh; Chaudhri, Irtaza; Fleming, Jessica A; Munier, Aline; Baradaran, Hamid R

    2015-05-07

    Although the mortality from diarrheal diseases has been decreasing dramatically in Iran, it still represents an important proportion of disease burden in children Rotavirus vaccines are among the most effective strategies against diarrheal diseases in specific epidemiological conditions. This study aimed to evaluate the cost-effectiveness of the introduction of rotavirus vaccine (3 doses of pentavalent RotaTeq (RV5)) in Iran, from the viewpoints of Iran's health system and society. The TRIVAC decision support model was used to calculate total incremental costs, life years (LYs) gained, and disability-adjusted life years (DALYs) averted due to the vaccination program. Necessary input data were collected from the most valid accessible sources as well as a systematic review and meta-analysis on epidemiological studies. We used WHO guidelines to estimate vaccination cost. An annual discount rate of 3% was considered for both health gain and costs. A deterministic sensitivity analysis was performed for testing the robustness of the models results. Our results indicated that total DALYs potentially lost due to rotavirus diarrhea within 10 years would be 138,161, of which 76,591 could be prevented by rotavirus vaccine. The total vaccination cost for 10 cohorts was estimated to be US$ 499.91 million. Also, US$ 470.61 million would be saved because of preventing outpatient visits and inpatient admissions (cost-saving from the society perspective). We estimated a cost per DALY averted of US$ 2868 for RV5 vaccination, which corresponds to a highly cost-effective strategy from the government perspective. In the sensitivity analysis, all scenarios tested were still cost-saving or highly cost-effective from the society perspective, except in the least favorable scenario and low vaccine efficacy and disease incidence scenario. Based on the findings, introduction of rotavirus vaccine is a highly cost-effective strategy from the government perspective. Introducing the vaccine to

  14. FreeWalker: a smart insole for longitudinal gait analysis.

    Science.gov (United States)

    Wang, Baitong; Rajput, Kuldeep Singh; Tam, Wing-Kin; Tung, Anthony K H; Yang, Zhi

    2015-08-01

    Gait analysis is an important diagnostic measure to investigate the pattern of walking. Traditional gait analysis is generally carried out in a gait lab, with equipped force and body tracking sensors, which needs a trained medical professional to interpret the results. This procedure is tedious, expensive, and unreliable and makes it difficult to track the progress across multiple visits. In this paper, we present a smart insole called FreeWalker, which provides quantitative gait analysis outside the confinement of traditional lab, at low- cost. The insole consists of eight pressure sensors and two motion tracking sensors, i.e. 3-axis accelerometer and 3-axis gyroscope. This enables measurement of under-foot pressure distribution and motion sequences in real-time. The insole is enabled with onboard SD card as well as wireless data transmission, which help in continuous gait-cycle analysis. The data is then sent to a gateway, for analysis and interpretation of data, using a user interface where gait features are graphically displayed. We also present validation result of a subject's left foot, who was asked to perform a specific task. Experiment results show that we could achieve a data-sampling rate of over 1 KHz, transmitting data up to a distance of 20 meter and maintain a battery life of around 24 hours. Taking advantage of these features, FreeWalker can be used in various applications, like medical diagnosis, rehabilitation, sports and entertainment.

  15. Seasonal influenza vaccination for children in Thailand: a cost-effectiveness analysis.

    Science.gov (United States)

    Meeyai, Aronrag; Praditsitthikorn, Naiyana; Kotirum, Surachai; Kulpeng, Wantanee; Putthasri, Weerasak; Cooper, Ben S; Teerawattananon, Yot

    2015-05-01

    Seasonal influenza is a major cause of mortality worldwide. Routine immunization of children has the potential to reduce this mortality through both direct and indirect protection, but has not been adopted by any low- or middle-income countries. We developed a framework to evaluate the cost-effectiveness of influenza vaccination policies in developing countries and used it to consider annual vaccination of school- and preschool-aged children with either trivalent inactivated influenza vaccine (TIV) or trivalent live-attenuated influenza vaccine (LAIV) in Thailand. We also compared these approaches with a policy of expanding TIV coverage in the elderly. We developed an age-structured model to evaluate the cost-effectiveness of eight vaccination policies parameterized using country-level data from Thailand. For policies using LAIV, we considered five different age groups of children to vaccinate. We adopted a Bayesian evidence-synthesis framework, expressing uncertainty in parameters through probability distributions derived by fitting the model to prospectively collected laboratory-confirmed influenza data from 2005-2009, by meta-analysis of clinical trial data, and by using prior probability distributions derived from literature review and elicitation of expert opinion. We performed sensitivity analyses using alternative assumptions about prior immunity, contact patterns between age groups, the proportion of infections that are symptomatic, cost per unit vaccine, and vaccine effectiveness. Vaccination of children with LAIV was found to be highly cost-effective, with incremental cost-effectiveness ratios between about 2,000 and 5,000 international dollars per disability-adjusted life year averted, and was consistently preferred to TIV-based policies. These findings were robust to extensive sensitivity analyses. The optimal age group to vaccinate with LAIV, however, was sensitive both to the willingness to pay for health benefits and to assumptions about contact

  16. On longitudinal analysis of poverty conceptualised as a fuzzy state

    OpenAIRE

    Gianni Betti; Bruno Cheli; Vijay Verma

    2006-01-01

    When poverty is viewed as a matter of degree, i.e. as a fuzzy measure, two additional aspects are introduced into the analysis compared with the conventional poor/non-poor dichotomous approach: (i) the choice of membership functions i.e. quantitative specification of individuals' or households' degrees of poverty and deprivation; and (ii) the choice of rules for the manipulation of the resulting fuzzy sets, rules defining their complements, intersections, union and averaging. Specifically, fo...

  17. A periodic analysis of longitudinal binary responses: a case study of clinical mastitis in Norwegian Red cows

    Directory of Open Access Journals (Sweden)

    Heringstad Bjørg

    2007-04-01

    Full Text Available Abstract A Bayesian procedure for analyzing longitudinal binary responses using a periodic cosine function was developed. It was assumed that, after adjustment for "seasonal" effects, the oscillation of the underlying latent variables for longitudinal binary responses was a stationary series. Based on this assumption, a single dimension sinusoidal analysis of longitudinal binary responses using the Gibbs sampling and Metropolis algorithms was implemented in a study of clinical mastitis records of Norwegian Red cows taken over five lactations.

  18. CONSTRUCTION AND ANALYSIS OF DECISION-MAKING MODEL IN ASSESSING THE IMPACT OF VACCINATION WITH ROTAVIRUS VACCINE IN UKRAINE

    Directory of Open Access Journals (Sweden)

    S. O. Solovyov

    2012-11-01

    Full Text Available The results of computational and theoretical studies related to assessing of efficiency indicators of immunization with rotavirus vaccine in Ukraine among children under five years are presented. The Indicators of the impact were received with computer implementation of decision tree model based on Markov processes. Under strategies of vaccination and no vaccination projected levels of morbidity, number of hospital admissions, mortality of rotavirus infection and other factors were received. It was shown that the vaccination with rotavirus vaccine will have significant medical significance in Ukraine.

  19. Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children.

    Science.gov (United States)

    Mezones-Holguín, Edward; Bolaños-Díaz, Rafael; Fiestas, Víctor; Sanabria, César; Gutiérrez-Aguado, Alfonso; Fiestas, Fabián; Suárez, Víctor J; Rodriguez-Morales, Alfonso J; Hernández, Adrián V

    2014-12-15

    Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 years-old. A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, and USD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

  20. Large-scale comparative analysis of pertussis population dynamics: periodicity, synchrony, and impact of vaccination.

    Science.gov (United States)

    Broutin, Hélène; Guégan, Jean-François; Elguero, Eric; Simondon, François; Cazelles, Bernard

    2005-06-15

    Pertussis is a worldwide infectious disease which persists despite massive vaccination campaigns that have gone on for several decades. To obtain an overall view of pertussis dynamics and the impact of vaccination, the authors performed, using the wavelet method, a comparative analysis of pertussis time series in 12 countries to detect and quantify periodicity and synchrony between them. Results showed a clear 3- to 4-year cycle in all countries, but the main finding was that this periodicity was transient. No global pattern in the effect of vaccination on pertussis dynamics was observed, but some spatial synchrony between countries was detected. This large-scale comparative analysis of pertussis dynamics sheds light on the complexity of the multiple interactions involved in global pertussis spatial dynamic patterns. It suggests a need to perform a global survey of human infectious diseases over the long term, which would permit better assessment of the risk of disease outbreaks in the future.

  1. Efficacy of fewer than three doses of an HPV-16/18 AS04-adjuvanted vaccine: combined analysis of data from the Costa Rica Vaccine and PATRICIA Trials.

    Science.gov (United States)

    Kreimer, Aimée R; Struyf, Frank; Del Rosario-Raymundo, Maria Rowena; Hildesheim, Allan; Skinner, S Rachel; Wacholder, Sholom; Garland, Suzanne M; Herrero, Rolando; David, Marie-Pierre; Wheeler, Cosette M; González, Paula; Jiménez, Silvia; Lowy, Douglas R; Pinto, Ligia A; Porras, Caroline; Rodriguez, Ana Cecilia; Safaeian, Mahboobeh; Schiffman, Mark; Schiller, John T; Schussler, John; Sherman, Mark E; Bosch, F Xavier; Castellsague, Xavier; Chatterjee, Archana; Chow, Song-Nan; Descamps, Dominique; Diaz-Mitoma, Francisco; Dubin, Gary; Germar, Maria Julieta; Harper, Diane M; Lewis, David J M; Limson, Genara; Naud, Paulo; Peters, Klaus; Poppe, Willy A J; Ramjattan, Brian; Romanowski, Barbara; Salmeron, Jorge; Schwarz, Tino F; Teixeira, Julio C; Tjalma, Wiebren A A

    2015-07-01

    There is some evidence to suggest that one or two doses of the HPV vaccine provides similar protection to the three-dose regimen. The main aim of the study was to ascertain HPV-16/18 vaccine efficacy in both full and naive cohorts and to explore protection conferred against non-vaccine HPV types, by number of doses received. Summary data from the Costa Rica Vaccine Trial (CVT; NCT00128661) and ~the PATRICIA trial (NCT001226810), two phase 3, double-blind, randomised controlled clinical trials of the HPV-16/18 AS04-adjuvanted vaccine in young women, were combined in a post-hoc analysis (GlaxoSmithKline [GSK] e-track number 202142) to investigate the efficacy of fewer than three doses of the HPV-16/18 vaccine after 4 years of follow-up. Women were randomly assigned to receive three doses of the HPV-16/18 vaccine or to a control vaccine; yet, some received fewer doses. After exclusion of women with less than 12 months of follow-up or those who were HPV-16/18 DNA-positive at enrolment (for the HPV-16/18 endpoint), we calculated vaccine efficacy against one-time detection of incident HPV infections after three, two, and one dose(s). The primary study endpoint was one-time detection of first incident HPV-16/18 infections accumulated during the follow-up phase. We assessed vaccine efficacy against incident HPV-16/18 infection in the modified total vaccinated cohort (22 327 received three doses, 1185 two doses, 543 one dose). Vaccine efficacy against incident HPV-16/18 infections for three doses was 77·0% (95% CI 74·7-79·1), two doses was 76·0% (62·0-85·3), and one dose was 85·7% (70·7-93·7). Vaccine efficacy against incident HPV-31/33/45 infections for three doses was 59·7% (56·0-63·0), two doses was 37·7% (12·4-55·9), and one dose was 36·6% (-5·4 to 62·2). Vaccine efficacy against incident HPV-16/18 infection for two-dose women who received their second dose at 1 month was 75·3% (54·2-87·5) and 82·6% (42·3-96·1) for those who received the second

  2. Biopower, Normalization, and HPV: A Foucauldian Analysis of the HPV Vaccine Controversy.

    Science.gov (United States)

    Engels, Kimberly S

    2016-09-01

    This article utilizes the Foucauldian concepts of biopower and normalization to give an analysis of the debate surrounding the controversial administration of the HPV vaccine to adolescents. My intention is not to solve the problem, rather to utilize a Foucauldian framework to bring various facets of the issue to light, specifically the way the vaccine contributes to strategies of power in reference to how young adults develop within relationships of power. To begin, the article provides an overview of the Foucauldian concepts of biopower and normalization, including how these two strategies of power were present in the administration of the smallpox vaccine in the 19th century. Next, information about HPV and the history of the current controversy in the United States is presented. Lastly, the article presents an analysis of the strategies of biopower and normalization present in the debate on HPV, including an emphasis on how the vaccination is similar to, and different from, 19th century smallpox vaccination. It also explores the way that mechanisms of disease control affect and are affected by individual subjects, in this case, adolescents.

  3. Immunoproteomics analysis of the murine antibody response to vaccination with an improved Francisella tularensis live vaccine strain (LVS.

    Directory of Open Access Journals (Sweden)

    Susan M Twine

    2010-04-01

    Full Text Available Francisella tularensis subspecies tularensis is the causative agent of a spectrum of diseases collectively known as tularemia. An attenuated live vaccine strain (LVS has been shown to be efficacious in humans, but safety concerns have prevented its licensure by the FDA. Recently, F. tularensis LVS has been produced under Current Good Manufacturing Practice (CGMP guidelines. Little is known about the immunogenicity of this new vaccine preparation in comparison with extensive studies conducted with laboratory passaged strains of LVS. Thus, the aim of the current work was to evaluate the repertoire of antibodies produced in mouse strains vaccinated with the new LVS vaccine preparation.In the current study, we used an immunoproteomics approach to examine the repertoire of antibodies induced following successful immunization of BALB/c versus unsuccessful vaccination of C57BL/6 mice with the new preparation of F. tularensis LVS. Successful vaccination of BALB/c mice elicited antibodies to nine identified proteins that were not recognized by antisera from vaccinated but unprotected C57BL/6 mice. In addition, the CGMP formulation of LVS stimulated a greater repertoire of antibodies following vaccination compared to vaccination with laboratory passaged ATCC LVS strain. A total of 15 immunoreactive proteins were identified in both studies, however, 16 immunoreactive proteins were uniquely reactive with sera from the new formulation of LVS.This is the first report characterising the antibody based immune response of the new formulation of LVS in the widely used murine model of tularemia. Using two mouse strains, we show that successfully vaccinated mice can be distinguished from unsuccessfully vaccinated mice based upon the repertoire of antibodies generated. This opens the door towards downselection of antigens for incorporation into tularemia subunit vaccines. In addition, this work also highlights differences in the humoral immune response to

  4. Childhood vaccination in informal urban settlements in Nairobi, Kenya: Who gets vaccinated?

    Directory of Open Access Journals (Sweden)

    Ettarh Remare R

    2011-01-01

    Full Text Available Abstract Background Recent trends in global vaccination coverage have shown increases with most countries reaching 90% DTP3 coverage in 2008, although pockets of undervaccination continue to persist in parts of sub-Saharan Africa particularly in the urban slums. The objectives of this study were to determine the vaccination status of children aged between 12-23 months living in two slums of Nairobi and to identify the risk factors associated with incomplete vaccination. Methods The study was carried out as part of a longitudinal Maternal and Child Health study undertaken in Korogocho and Viwandani slums of Nairobi. These slums host the Nairobi Urban Health and Demographic Surveillance System (NUHDSS run by the African Population and Health Research Centre (APHRC. All women from the NUHDSS area who gave birth since September 2006 were enrolled in the project and administered a questionnaire which asked about the vaccination history of their children. For the purpose of this study, we used data from 1848 children aged 12-23 months who were expected to have received all the WHO-recommended vaccinations. The vaccination details were collected during the first visit about four months after birth with follow-up visits repeated thereafter at four month intervals. Full vaccination was defined as receiving all the basic childhood vaccinations by the end of 24 months of life, whereas up-to-date (UTD vaccination referred to receipt of BCG, OPV 1-3, DTP 1-3, and measles vaccinations within the first 12 months of life. All vaccination data were obtained from vaccination cards which were sighted during the household visit as well as by recall from mothers. Multivariate models were used to identify the risk factors associated with incomplete vaccination. Results Measles coverage was substantially lower than that for the other vaccines when determined using only vaccination cards or in addition to maternal recall. Up-to-date (UTD coverage with all vaccinations

  5. Removing the age restrictions for rotavirus vaccination: a benefit-risk modeling analysis.

    Directory of Open Access Journals (Sweden)

    Manish M Patel

    additional 47,200 rotavirus deaths (18,700-63,700 and cause an additional 294 (161-471 intussusception deaths, for an incremental benefit-risk ratio of 154 deaths averted for every death caused by vaccine. These extra deaths prevented under an unrestricted schedule reflect vaccination of an additional 21%-25% children, beyond the 63%-73% of the children who would be vaccinated under the restricted schedule. Importantly, these estimates err on the side of safety in that they assume high vaccine-associated risk of intussusception and do not account for potential herd immunity or non-fatal outcomes. CONCLUSIONS: Our analysis suggests that in low- and middle-income countries the additional lives saved by removing age restrictions for rotavirus vaccination would far outnumber the potential excess vaccine-associated intussusception deaths. Please see later in the article for the Editors' Summary.

  6. Human papillomavirus vaccination uptake in Canada: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yelena Bird

    2017-01-01

    Full Text Available Human papillomavirus (HPV is the most commonly sexually transmitted infection in the world and the primary cause of cervical cancer. Canada introduced publicly funded HPV vaccination programs in 2006. The objectives of this study are twofold and aim to (1 determine the levels and (2 examine the various factors influencing vaccine uptake among the general Canadian population. A literature search was conducted on seven databases, followed by screening, methodological quality review (using modified Newcastle-Ottawa Scale, and data extraction. Pooled meta-analysis and a subgroup analysis were conducted stratifying by a number of variables (age, sex, type of program, and method of payment determined apriori. A total of 718 peer-reviewed articles were initially identified with 12 remaining after screening and underwent methodological quality review. HPV vaccination uptake in Canada varied from 12.40% (95% confidence interval [CI] 6.77–20.26 to 88.20% (95% CI 85.72–90.39. The pooled random effects model showed the HPV vaccination uptake to be 55.92% (95% CI 44.87–66.65. The subgroup analysis showed that vaccination uptake was 66.95% (95% CI 55.00–77.89 in participants ≤ 18 years as compared to 13.58% (95% CI 10.93–16.46 in participants > 18 years. Uptake for females was higher 57.23% (95% CI: 45.40–68.66 when compared to that of 47.01% (95% CI: 0.82–97.75 in males. HPV vaccine uptake among school-based programs was 69.62% (95% CI 57.27–80.68 as compared to 18.66% (95% CI 6.66–34.92 for community-based programs. Vaccination uptake for publicly funded programs was significantly higher 66.95% (95% CI 55.00–77.89 when compared to 13.58% (95% CI 10.92–16.46 for programs where participants had to pay out of pocket. To prevent infections and reduce the burden of HPV-related diseases (including cervical cancer, communities should be made aware and encouraged to vaccinate their children. There is a documented need to direct effort and

  7. Unlocking Barriers to DNA Vaccine Immunogenicity: A Cross-Species Analysis of Cytosolic DNA Sensing in Skeletal Muscle Myocytes

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-15-1-0505 TITLE: Unlocking Barriers to DNA Vaccine Immunogenicity: A Cross-Species Analysis of Cytosolic DNA Sensing in...REPORT TYPE Annual 3. DATES COVERED 10 Sept 2016 – 9 Sept 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Unlocking Barriers to DNA Vaccine ...DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT DNA vaccine technology holds

  8. A cost-utility analysis of adding a bivalent or quadrivalent HPV vaccine to the Irish cervical screening programme.

    LENUS (Irish Health Repository)

    Dee, Anne

    2010-04-01

    Cervical cancer is a leading cause of death worldwide, and in Ireland it is the ninth most commonly diagnosed cancer in women. Almost 100% of these cancers are caused by human papillomavirus (HPV) infection. Two newly developed vaccines against HPV infection have become available. This study is a cost-utility analysis of the HPV vaccine in Ireland, and it compares the cost-effectiveness profiles of the two vaccines.

  9. Perceptions of HPV and attitudes towards HPV vaccination amongst men who have sex with men: A qualitative analysis.

    Science.gov (United States)

    Nadarzynski, Tom; Smith, Helen; Richardson, Daniel; Pollard, Alex; Llewellyn, Carrie

    2017-05-01

    Men who have sex with men (MSM) are at risk of genital warts and anal cancer due to human papillomavirus (HPV) infection. This study explores MSMs' perceptions of HPV and HPV vaccination prior to the introduction of this programme. Focus groups and one-to-one interviews with self-identified MSM were conducted between November 2014 and March 2015 in Brighton, UK. Participants were recruited from community-based lesbian-gay-bisexual-transgender (LGBT) venues and organizations. Discussions were recorded, transcribed verbatim, and analysed using framework analysis. Thirty-three men took part (median age 25 years, IQR: 21-27), most of whom (n = 25) did not know about HPV, anal cancer (31), or HPV vaccination (26). While genital warts and anal cancer were perceived as severe, men did not perceive themselves at risk of HPV. All MSM would accept the HPV vaccine if offered by a health care professional. The challenges of accessing sexual health services or openly discussing same-sex experiences with health care professionals were perceived as barriers to accessing HPV vaccination. Two participants were concerned that selective HPV vaccination could increase stigma and prejudice against MSM, comparable to the AIDS epidemic. Ten MSM were unsure about the effectiveness of HPV vaccination for sexually active men and were in favour of vaccinating all adolescent boys at school. Most MSM have poor knowledge about HPV and associated anal cancer. Despite the lack of concern about HPV, most MSM expressed willingness to receive HPV vaccination. There is a need for health education about the risks of HPV and HPV-related diseases so that MSM can appraise the benefits of being vaccinated. Concerns about HPV vaccine effectiveness in sexually active men and possible stigmatization need to be addressed to optimize HPV vaccine acceptability. Statement of contribution What is already known on this subject? Men who have sex with men (MSM) have poor knowledge about HPV and HPV

  10. A Longitudinal Analysis of Publications on Maternal Mortality.

    Science.gov (United States)

    de Groot, Christianne J M; van Leeuwen, Thed; Mol, Ben Willem J; Waltman, Ludo

    2015-11-01

    The fifth Millennium Development Goal formulated by the WHO in 2000 aimed to reduce global maternal mortality by 75% in 2015. We studied the extent to which medical research has supported this by studying maternal mortality. We performed a bibliometric analysis of the literature on maternal mortality and of the development of this literature over time. We searched for publications on maternal mortality in the Web of Science database in the period 1994-2013. We visualised the subjects of these publications using a term map showing the most significant terms occurring in the titles and abstracts of publications on maternal mortality. We identified 3794 publications on maternal mortality in Web of Science. The annual number increased from 87 in 1994 to 397 in 2013. The largest number of maternal mortality publications was found in the field of Obstetrics and Gynecology, followed by the Public, Environmental, and Occupational Health field (increase from 1994 until 2013 of 300% and 700%, respectively). In both fields, the number of maternal mortality publications has increased at a much higher rate than the overall number of publications in the field. In line with the focus of the fifth Millennium Development Goal on reducing maternal mortality, during the past 20 years, there has been a steady increase in the amount of attention paid to maternal mortality in the medical literature. This is largely driven by an increase, mainly in recent years, in public health research on maternal mortality. © 2015 John Wiley & Sons Ltd.

  11. Vaccinations and childhood type 1 diabetes mellitus: a meta-analysis of observational studies.

    Science.gov (United States)

    Morgan, Eileen; Halliday, Sophia R; Campbell, Gemma R; Cardwell, Chris R; Patterson, Chris C

    2016-02-01

    The aim of this study was to investigate the association between routine vaccinations and the risk of childhood type 1 diabetes mellitus by systematically reviewing the published literature and performing meta-analyses where possible. A comprehensive literature search was performed of MEDLINE and EMBASE to identify all studies that compared vaccination rates in children who subsequently developed type 1 diabetes mellitus and in control children. ORs and 95% CIs were obtained from published reports or derived from individual patient data and then combined using a random effects meta-analysis. In total, 23 studies investigating 16 vaccinations met the inclusion criteria. Eleven of these contributed to meta-analyses which included data from between 359 and 11,828 childhood diabetes cases. Overall, there was no evidence to suggest an association between any of the childhood vaccinations investigated and type 1 diabetes mellitus. The pooled ORs ranged from 0.58 (95% CI 0.24, 1.40) for the measles, mumps and rubella (MMR) vaccination in five studies up to 1.04 (95% CI 0.94, 1.14) for the haemophilus influenza B (HiB) vaccination in 11 studies. Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with high methodology quality scores. Neither this restriction by quality nor the original authors' adjustments for potential confounding made a substantial difference to the pooled ORs. This study provides no evidence of an association between routine vaccinations and childhood type 1 diabetes.

  12. Critical Analysis of Compositions and Protective Efficacies of Oral Killed Cholera Vaccines

    Science.gov (United States)

    2014-01-01

    Two cholera vaccines, sold as Shanchol and Dukoral, are currently available. This review presents a critical analysis of the protective efficacies of these vaccines. Children under 5 years of age are very vulnerable to cholera and account for the highest incidence of cholera cases and more than half of the resulting deaths. Both Shanchol and Dukoral are two-spaced-dose oral vaccines comprising large numbers of killed cholera bacteria. The former contains Vibrio cholerae O1 and O139 cells, and the latter contains V. cholerae O1 cells with the recombinant B subunit of cholera toxin. In a field trial in Kolkata (India), Shanchol, the preferred vaccine, protected 45% of the test subjects in all of the age groups and only 17% of the children under 5 years of age during the first year of surveillance. In a field trial in Peru, two spaced doses of Dukoral offered negative protection in children under 5 years of age and little protection (15%) in vaccinees over 6 years of age during the first year of surveillance. Little is known about Dukoral's long-term protective efficacy. Both of these vaccines have questionable compositions, using V. cholerae O1 strains isolated in 1947 that have been inactivated by heat and formalin treatments that may denature protein. Immunological studies revealed Dukoral's reduced and short-lived efficacy, as measured by several immunological endpoints. Various factors, such as the necessity for multiple doses, poor protection of children under 5 years of age, the requirement of a cold supply chain, production costs, and complex logistics of vaccine delivery, greatly reduce the suitability of either of these vaccines for endemic or epidemic cholera control in resource-poor settings. PMID:25056361

  13. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    Science.gov (United States)

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-01-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109

  14. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data.

    Science.gov (United States)

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-09-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination.

  15. Model selection for marginal regression analysis of longitudinal data with missing observations and covariate measurement error.

    Science.gov (United States)

    Shen, Chung-Wei; Chen, Yi-Hau

    2015-10-01

    Missing observations and covariate measurement error commonly arise in longitudinal data. However, existing methods for model selection in marginal regression analysis of longitudinal data fail to address the potential bias resulting from these issues. To tackle this problem, we propose a new model selection criterion, the Generalized Longitudinal Information Criterion, which is based on an approximately unbiased estimator for the expected quadratic error of a considered marginal model accounting for both data missingness and covariate measurement error. The simulation results reveal that the proposed method performs quite well in the presence of missing data and covariate measurement error. On the contrary, the naive procedures without taking care of such complexity in data may perform quite poorly. The proposed method is applied to data from the Taiwan Longitudinal Study on Aging to assess the relationship of depression with health and social status in the elderly, accommodating measurement error in the covariate as well as missing observations. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Analysis of Longitudinal Waves in Rod-Type Piezoelectric Phononic Crystals

    Directory of Open Access Journals (Sweden)

    Longfei Li

    2016-04-01

    Full Text Available Phononic crystals can be used to control elastic waves due to their frequency bands. This paper analyzes the passive and active control as well as the dispersion properties of longitudinal waves in rod-type piezoelectric phononic crystals over large frequency ranges. Based on the Love rod theory for modeling the longitudinal wave motions in the constituent rods and the method of reverberation-ray matrix (MRRM for deriving the member transfer matrices of the constituent rods, a modified transfer matrix method (MTMM is proposed for the analysis of dispersion curves by combining with the Floquet–Bloch principle and for the calculation of transmission spectra. Numerical examples are provided to validate the proposed MTMM for analyzing the band structures in both low and high frequency ranges. The passive control of longitudinal-wave band structures is studied by discussing the influences of the electrode’s thickness, the Poisson’s effect and the elastic rod inserts in the unit cell. The influences of electrical boundaries (including electric-open, applied electric capacity, electric-short and applied feedback control conditions on the band structures are investigated to illustrate the active control scheme. From the calculated comprehensive frequency spectra over a large frequency range, the dispersion properties of the characteristic longitudinal waves in rod-type piezoelectric phononic crystals are summarized.

  17. Global foot-and-mouth disease research update and gap analysis: 3 - vaccines

    Science.gov (United States)

    In 2014, the Global Foot-and-mouth disease Research Alliance (GFRA) conducted a gap analysis of FMD research. In this paper, we report updated findings in the field of FMD vaccine research. This paper consists of the following four sections: 1) Research priorities identified in the 2010 GFRA gap ana...

  18. Adverse events following 12 and 18 month vaccinations: a population-based, self-controlled case series analysis.

    Directory of Open Access Journals (Sweden)

    Kumanan Wilson

    Full Text Available BACKGROUND: Live vaccines have distinct safety profiles, potentially causing systemic reactions one to 2 weeks after administration. In the province of Ontario, Canada, live MMR vaccine is currently recommended at age 12 months and 18 months. METHODS: Using the self-controlled case series design we examined 271,495 12 month vaccinations and 184,312 18 month vaccinations to examine the relative incidence of the composite endpoint of emergency room visits or hospital admissions in consecutive one day intervals following vaccination. These were compared to a control period 20 to 28 days later. In a post-hoc analysis we examined the reasons for emergency room visits and the average acuity score at presentation for children during the at-risk period following the 12 month vaccine. RESULTS: Four to 12 days post 12 month vaccination, children had a 1.33 (1.29-1.38 increased relative incidence of the combined endpoint compared to the control period, or at least one event during the risk interval for every 168 children vaccinated. Ten to 12 days post 18 month vaccination, the relative incidence was 1.25 (95%, 1.17-1.33 which represented at least one excess event for every 730 children vaccinated. The primary reason for increased events was statistically significant elevations in emergency room visits following all vaccinations. There were non-significant increases in hospital admissions. There were an additional 20 febrile seizures for every 100,000 vaccinated at 12 months. CONCLUSIONS: There are significantly elevated risks of primarily emergency room visits approximately one to two weeks following 12 and 18 month vaccination. Future studies should examine whether these events could be predicted or prevented.

  19. A Cost Effectiveness and Capacity Analysis for the Introduction of Universal Rotavirus Vaccination in Kenya: Comparison between Rotarix and RotaTeq Vaccines

    Science.gov (United States)

    van Hoek, Albert Jan; Ngama, Mwanajuma; Ismail, Amina; Chuma, Jane; Cheburet, Samuel; Mutonga, David; Kamau, Tatu; Nokes, D. James

    2012-01-01

    Background Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination. Methods Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain. Results The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix. Conclusion Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability. PMID:23115650

  20. Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review.

    Science.gov (United States)

    Mogasale, Vittal; Ramani, Enusa; Wee, Hyeseung; Kim, Jerome H

    2016-12-01

    Use of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers. To review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries. Peer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination. The publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014. No participants are involved, only costs are collected. Oral cholera vaccination and cost estimation. A systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$). Ten studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014). The reported cost categories

  1. Longitudinal analysis of categorical epidemiological data: a study of Three Mile Island.

    OpenAIRE

    Fienberg, S. E.; Bromet, E.J.; Follmann, D; Lambert, D; S. M. May

    1985-01-01

    The accident at the Three Mile Island nuclear power plant in 1979 led to an unprecedented set of events with potentially life threatening implications. This paper focusses on the analysis of a longitudinal study of the psychological well-being of the mothers of young children living within 10 miles of the plant. The initial analyses of the data utilize loglinear/logit model techniques from the contingency table literature, and involve the fitting of a sequence of logit models. The inadequanci...

  2. Linking Integration and Housing Career: A Longitudinal Analysis of Immigrant Groups in Sweden

    OpenAIRE

    Turner, Lena Magnusson; Hedman, Lina

    2014-01-01

    ABSTRACT This study investigates the extent to which immigrant groups are integrated in the Stockholm region through an analysis of their housing careers. Housing conditions are linked to many important life course events, as well as to the resources and preferences of each individual family. Housing conditions influence integration, but factors related to integration can also be a cause of housing conditions. In the study, we take a truly longitudinal approach to housing careers by exploring...

  3. Statistical and Ontological Analysis of Adverse Events Associated with Monovalent and Combination Vaccines against Hepatitis A and B Diseases

    Science.gov (United States)

    Xie, Jiangan; Zhao, Lili; Zhou, Shangbo; He, Yongqun

    2016-01-01

    Vaccinations often induce various adverse events (AEs), and sometimes serious AEs (SAEs). While many vaccines are used in combination, the effects of vaccine-vaccine interactions (VVIs) on vaccine AEs are rarely studied. In this study, AE profiles induced by hepatitis A vaccine (Havrix), hepatitis B vaccine (Engerix-B), and hepatitis A and B combination vaccine (Twinrix) were studied using the VAERS data. From May 2001 to January 2015, VAERS recorded 941, 3,885, and 1,624 AE case reports where patients aged at least 18 years old were vaccinated with only Havrix, Engerix-B, and Twinrix, respectively. Using these data, our statistical analysis identified 46, 69, and 82 AEs significantly associated with Havrix, Engerix-B, and Twinrix, respectively. Based on the Ontology of Adverse Events (OAE) hierarchical classification, these AEs were enriched in the AEs related to behavioral and neurological conditions, immune system, and investigation results. Twenty-nine AEs were classified as SAEs and mainly related to immune conditions. Using a logistic regression model accompanied with MCMC sampling, 13 AEs (e.g., hepatosplenomegaly) were identified to result from VVI synergistic effects. Classifications of these 13 AEs using OAE and MedDRA hierarchies confirmed the advantages of the OAE-based method over MedDRA in AE term hierarchical analysis. PMID:27694888

  4. medplot: a web application for dynamic summary and analysis of longitudinal medical data based on R.

    Directory of Open Access Journals (Sweden)

    Črt Ahlin

    Full Text Available In biomedical studies the patients are often evaluated numerous times and a large number of variables are recorded at each time-point. Data entry and manipulation of longitudinal data can be performed using spreadsheet programs, which usually include some data plotting and analysis capabilities and are straightforward to use, but are not designed for the analyses of complex longitudinal data. Specialized statistical software offers more flexibility and capabilities, but first time users with biomedical background often find its use difficult. We developed medplot, an interactive web application that simplifies the exploration and analysis of longitudinal data. The application can be used to summarize, visualize and analyze data by researchers that are not familiar with statistical programs and whose knowledge of statistics is limited. The summary tools produce publication-ready tables and graphs. The analysis tools include features that are seldom available in spreadsheet software, such as correction for multiple testing, repeated measurement analyses and flexible non-linear modeling of the association of the numerical variables with the outcome. medplot is freely available and open source, it has an intuitive graphical user interface (GUI, it is accessible via the Internet and can be used within a web browser, without the need for installing and maintaining programs locally on the user's computer. This paper describes the application and gives detailed examples describing how to use the application on real data from a clinical study including patients with early Lyme borreliosis.

  5. Cost-effectiveness analysis for Pap smear screening and human papillomavirus DNA testing and vaccination.

    Science.gov (United States)

    Chen, Meng-Kan; Hung, Hui-Fang; Duffy, Stephen; Yen, Amy Ming-Fang; Chen, Hsiu-Hsi

    2011-12-01

    As the effectiveness of cytology-based screening programme for cervical cancer in mortality reduction has reached a plateau, various preventive strategies have been considered, including intensive Pap smear screening and the supplemental use of human papillomavirus (HPV) DNA test or HPV vaccination. Cost and effectiveness of these various preventive strategies are therefore of great concern for health policy makers. We intended to assess whether the combination of HPV DNA testing or HPV vaccination with Pap smear screening programme or the sole annual Pap smear screening is more effective and cost-effective in prevention of cervical cancer than the existing triennial Pap smear screening programme. A Markov decision model was constructed to compare total costs and effectiveness between different preventive strategies (including annual Pap smear, HPV DNA testing or HPV vaccination together with Pap smear screening programme) as opposed to the triennial Pap smear screening alone (the comparator). Probabilistic cost-effectiveness (C-E) analysis was adopted to plot a series of simulated incremental C-E ratios scattered over C-E plane and also to yield the acceptability curve for different comparisons of strategies. The threshold of vaccine cost and the influence of attendance rate were also investigated. Compared with triennial Pap smear screening programme, most of preventive strategies cost more but gain additional life years (quadrant I of C-E plane) except HPV DNA testing with Pap smear every 5 years dominated by triennial Pap smear screening programme. The most cost-effective strategy was annual Pap smear (incremental C-E ratio = $31 698), followed by HPV DNA testing with Pap smear every 3 years ($36 627), and vaccination programme with triennial Pap smear screening ($44 688) with the corresponding cost-effective probabilities by the acceptability curve being 65.52%, 52.08% and 35.84% given the threshold of $40 000 of willingness to pay. Vaccination combined with

  6. A content analysis of mass media sources in relation to the MMR vaccine scare.

    Science.gov (United States)

    Guillaume, Louise; Bath, Peter A

    2008-12-01

    In light of the mass media coverage that the MMR (measles, mumps and rubella) vaccine received as a result of questions raised about its safety, a content analysis of mass media articles about the MMR vaccine was undertaken. The analysis examined 227 articles published in five different information sources in a 2 month period. The analysis looked at 94 content-based variables and the key attributes of these articles including word count and date of publication. Descriptive and analytical statistics relating to both article content and format were produced. The analysis showed that the content and format of articles between different information sources varied widely. These differences can be attributed to the information source in which they are published, but the variability in the content of these information sources provides a challenge to parents who were shown to be using the mass media as an information source.

  7. Effectiveness of 2009 pandemic influenza A(H1N1) vaccines: A systematic review and meta-analysis.

    Science.gov (United States)

    Lansbury, Louise E; Smith, Sherie; Beyer, Walter; Karamehic, Emina; Pasic-Juhas, Eva; Sikira, Hana; Mateus, Ana; Oshitani, Hitoshi; Zhao, Hongxin; Beck, Charles R; Nguyen-Van-Tam, Jonathan S

    2017-04-11

    The clinical effectiveness of monovalent influenza A(H1N1)pdm09 vaccines has not been comprehensively summarised. We undertook a systematic review and meta-analysis to assess vaccine effectiveness (VE) for adjuvanted and unadjuvanted vaccines. We searched healthcare databases and grey literature from 11 June 2009 to 12 November 2014. Two researchers independently assessed titles and abstracts to identify studies for full review. Random effects meta-analyses estimated the pooled effect size of vaccination compared to placebo or no vaccination for crude and adjusted odds ratios (OR) to prevent laboratory confirmed influenza illness (LCI) and related hospitalization. VE was calculated as (1-pooled OR)∗100. Narrative synthesis was undertaken where meta-analysis was not possible. We identified 9229 studies of which 38 at moderate risk of bias met protocol eligibility criteria; 23 were suitable for meta-analysis. Pooled adjusted VE against LCI with adjuvanted and unadjuvanted vaccines both reached statistical significance (adjuvanted: VE=80%; 95% confidence interval [CI] 59-90%; unadjuvanted: VE=66%; 95% CI 47-78%); in planned secondary analyses, VE in adults often failed to reach statistical significance and pooled point estimates were lower than observed in children. Overall pooled adjusted VE against hospitalization was 61% (95% CI 14-82%); in planned secondary analyses, adjusted VE attained statistical significance in adults aged 18-64years and children for adjuvanted vaccines. Adjuvanted vaccines were significantly more effective in children compared to adults for both outcomes. Adjuvanted and unadjuvanted monovalent influenza A(H1N1)pdm09 vaccines were both effective in preventing LCI. Overall, the vaccines were also effective against influenza-related hospitalization. For both outcomes adjuvanted vaccines were more effective in children than in adults. Copyright © 2017. Published by Elsevier Ltd.

  8. AIDS vaccines that allow HIV-1 to infect and escape immunologic control - A mathematic analysis of mass vaccination

    NARCIS (Netherlands)

    van Ballegooijen, Marijn; Bogaards, Johannes A.; Weverling, Gerrit-Jan; Boerlijst, Maarten C.; Goudsmit, Jaap

    2003-01-01

    Cytotoxic T lymphocyte (CTL)-based HIV vaccine concepts shown to reduce viremia and postpone disease but not to prevent infection in monkeys are currently in human phase I trials. To evaluate the potential efficacy of vaccines that cannot prevent HIV-1 to infect and escape immunologic control, we

  9. Durability of Vaccine-Induced Immunity Against Tetanus and Diphtheria Toxins: A Cross-sectional Analysis

    Science.gov (United States)

    Hammarlund, Erika; Thomas, Archana; Poore, Elizabeth A.; Amanna, Ian J.; Rynko, Abby E.; Mori, Motomi; Chen, Zunqiu; Slifka, Mark K.

    2016-01-01

    Background. Many adult immunization schedules recommend that tetanus and diphtheria vaccination be performed every 10 years. In light of current epidemiological trends of disease incidence and rates of vaccine-associated adverse events, the 10-year revaccination schedule has come into question. Methods. We performed cross-sectional analysis of serum antibody titers in 546 adult subjects stratified by age or sex. All serological results were converted to international units after calibration with international serum standards. Results. Approximately 97% of the population was seropositive to tetanus and diphtheria as defined by a protective serum antibody titer of ≥0.01 IU/mL. Mean antibody titers were 3.6 and 0.35 IU/mL against tetanus and diphtheria, respectively. Antibody responses to tetanus declined with an estimated half-life of 14 years (95% confidence interval, 11–17 years), whereas antibody responses to diphtheria were more long-lived and declined with an estimated half-life of 27 years (18–51 years). Mathematical models combining antibody magnitude and duration predict that 95% of the population will remain protected against tetanus and diphtheria for ≥30 years without requiring further booster vaccination. Conclusions. These studies demonstrate that durable levels of protective antitoxin immunity exist in the majority of vaccinated individuals. Together, this suggests that it may no longer be necessary to administer booster vaccinations every 10 years and that the current adult vaccination schedule for tetanus and diphtheria should be revisited. PMID:27060790

  10. Bayesian analysis of longitudinal Johne's disease diagnostic data without a gold standard test

    DEFF Research Database (Denmark)

    Wang, C.; Turnbull, B.W.; Nielsen, Søren Saxmose

    2011-01-01

    . An application is presented to an analysis of ELISA and fecal culture test outcomes in the diagnostic testing of paratuberculosis (Johne's disease) for a Danish longitudinal study from January 2000 to March 2003. The posterior probability criterion based on the Bayesian model with 4 repeated observations has......A Bayesian methodology was developed based on a latent change-point model to evaluate the performance of milk ELISA and fecal culture tests for longitudinal Johne's disease diagnostic data. The situation of no perfect reference test was considered; that is, no “gold standard.” A change...... an area under the receiver operating characteristic curve (AUC) of 0.984, and is superior to the raw ELISA (AUC = 0.911) and fecal culture (sensitivity = 0.358, specificity = 0.980) tests for Johne's disease diagnosis....

  11. A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers.

    Directory of Open Access Journals (Sweden)

    Ingrid T Katz

    Full Text Available In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto.The HPV vaccine was introduced to adolescents in low-income townships throughout South Africa as part of a nationwide trial to understand adolescent involvement in future vaccine research targeting human immunodeficiency virus (HIV. We performed in-depth semi-structured interviews with purposively-sampled adolescents and their care providers to understand what forces shaped HPV vaccine uptake. Interviews were recorded, transcribed, translated, and examined using thematic analysis.Of 224 adolescents recruited, 201 initiated the vaccine; 192 (95.5% received a second immunization; and 164 (81.6% completed three doses. In our qualitative study of 39 adolescent-caregiver dyads, we found that factors driving vaccine uptake reflected a socio-cultural backdrop of high HIV endemnicity, sexual violence, poverty, and an abundance of female-headed households. Adolescents exercised a high level of autonomy and often initiated decision-making. Healthcare providers and peers provided support and guidance that was absent at home. The impact of the HIV epidemic on decision-making was substantial, leading participants to mistakenly conflate HPV and HIV.In a setting of perceived rampant sexual violence and epidemic levels of HIV, adolescents and caregivers sought to decrease harm by seeking a vaccine targeting a sexually transmitted infection (STI. Despite careful consenting, there was confusion regarding the vaccine's target. Future interventions promoting STI

  12. A qualitative analysis of factors influencing HPV vaccine uptake in Soweto, South Africa among adolescents and their caregivers.

    Science.gov (United States)

    Katz, Ingrid T; Nkala, Busisiwe; Dietrich, Janan; Wallace, Melissa; Bekker, Linda-Gail; Pollenz, Kathryn; Bogart, Laura M; Wright, Alexi A; Tsai, Alexander C; Bangsberg, David R; Gray, Glenda E

    2013-01-01

    In South Africa, the prevalence of oncogenic Human Papillomavirus (HPV) may be as high as 64%, and cervical cancer is the leading cause of cancer-related death among women. The development of efficacious prophylactic vaccines has provided an opportunity for primary prevention. Given the importance of psycho-social forces in vaccine uptake, we sought to elucidate factors influencing HPV vaccination among a sample of low-income South African adolescents receiving the vaccine for the first time in Soweto. The HPV vaccine was introduced to adolescents in low-income townships throughout South Africa as part of a nationwide trial to understand adolescent involvement in future vaccine research targeting human immunodeficiency virus (HIV). We performed in-depth semi-structured interviews with purposively-sampled adolescents and their care providers to understand what forces shaped HPV vaccine uptake. Interviews were recorded, transcribed, translated, and examined using thematic analysis. Of 224 adolescents recruited, 201 initiated the vaccine; 192 (95.5%) received a second immunization; and 164 (81.6%) completed three doses. In our qualitative study of 39 adolescent-caregiver dyads, we found that factors driving vaccine uptake reflected a socio-cultural backdrop of high HIV endemnicity, sexual violence, poverty, and an abundance of female-headed households. Adolescents exercised a high level of autonomy and often initiated decision-making. Healthcare providers and peers provided support and guidance that was absent at home. The impact of the HIV epidemic on decision-making was substantial, leading participants to mistakenly conflate HPV and HIV. In a setting of perceived rampant sexual violence and epidemic levels of HIV, adolescents and caregivers sought to decrease harm by seeking a vaccine targeting a sexually transmitted infection (STI). Despite careful consenting, there was confusion regarding the vaccine's target. Future interventions promoting STI vaccines will need

  13. Analysis of single nucleotide polymorphism among Varicella-Zoster Virus and identification of vaccine-specific sites.

    Science.gov (United States)

    Jeon, Jeong Seon; Won, Youn Hee; Kim, In Kyo; Ahn, Jin Hyun; Shin, Ok Sarah; Kim, Jung Hwan; Lee, Chan Hee

    2016-09-01

    Varicella-zoster virus (VZV) is a causative agent for chickenpox and zoster. Live attenuated vaccines have been developed based on Oka and MAV/06 strains. In order to understand the molecular mechanisms of attenuation, complete genome sequences of vaccine and wild-type strains were compared and single nucleotide polymorphism (SNP) was analyzed. ORF22 and ORF62 contained the highest number of SNPs. The detailed analysis of the SNPs suggested 24 potential vaccine-specific sites. All the mutational events found in vaccine-specific sites were transitional, and most of them were substitution of AT to GC pair. Interestingly, 18 of the vaccine-specific sites of the vaccine strains appeared to be genetically heterogeneous. The probability of a single genome of vaccine strain to contain all 24 vaccine-type sequences was calculated to be less than 4%. The average codon adaptation index (CAI) value of the vaccine strains was significantly lower than the CAI value of the clinical strains. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Ontology-based time information representation of vaccine adverse events in VAERS for temporal analysis

    Directory of Open Access Journals (Sweden)

    Tao Cui

    2012-12-01

    Full Text Available Abstract Background The U.S. FDA/CDC Vaccine Adverse Event Reporting System (VAERS provides a valuable data source for post-vaccination adverse event analyses. The structured data in the system has been widely used, but the information in the write-up narratives is rarely included in these kinds of analyses. In fact, the unstructured nature of the narratives makes the data embedded in them difficult to be used for any further studies. Results We developed an ontology-based approach to represent the data in the narratives in a “machine-understandable” way, so that it can be easily queried and further analyzed. Our focus is the time aspect in the data for time trending analysis. The Time Event Ontology (TEO, Ontology of Adverse Events (OAE, and Vaccine Ontology (VO are leveraged for the semantic representation of this purpose. A VAERS case report is presented as a use case for the ontological representations. The advantages of using our ontology-based Semantic web representation and data analysis are emphasized. Conclusions We believe that representing both the structured data and the data from write-up narratives in an integrated, unified, and “machine-understandable” way can improve research for vaccine safety analyses, causality assessments, and retrospective studies.

  15. Cost-effectiveness analysis of a universal vaccination programme with the 7-valent pneumococcal conjugate vaccine (PCV-7) in Sweden

    DEFF Research Database (Denmark)

    Bergman, Annika; Hjelmgren, Jonas; Ortqvist, Ake

    2008-01-01

    The 7-valent pneumococcal conjugate vaccine (PCV-7) has proved to be highly effective against invasive pneumococcal disease and has also provided some protection against all-cause pneumonia and acute otitis media. The objective of this study was to evaluate the projected health benefits, costs...... and cost-effectiveness of vaccination with the 7-valent conjugated pneumococcal vaccine compared with no vaccination, in all infants in Sweden, taking herd immunity into account. A Markov model was used and a hypothetical birth cohort was simulated for a lifelong perspective. The results show...... that vaccination of 1 cohort could potentially prevent 9 cases of pneumococcal meningitis, 22 cases of pneumococcal septicaemia, 509 cases of hospitalized pneumonia, 7812 cases of acute otitis media, and 2.7 fatalities, among children 0-4 y of age and 6 episodes of pneumococcal meningitis and 167 cases...

  16. Analysis of longitudinal data from animals with missing values using SPSS.

    Science.gov (United States)

    Duricki, Denise A; Soleman, Sara; Moon, Lawrence D F

    2016-06-01

    Testing of therapies for disease or injury often involves the analysis of longitudinal data from animals. Modern analytical methods have advantages over conventional methods (particularly when some data are missing), yet they are not used widely by preclinical researchers. Here we provide an easy-to-use protocol for the analysis of longitudinal data from animals, and we present a click-by-click guide for performing suitable analyses using the statistical package IBM SPSS Statistics software (SPSS). We guide readers through the analysis of a real-life data set obtained when testing a therapy for brain injury (stroke) in elderly rats. If a few data points are missing, as in this example data set (for example, because of animal dropout), repeated-measures analysis of covariance may fail to detect a treatment effect. An alternative analysis method, such as the use of linear models (with various covariance structures), and analysis using restricted maximum likelihood estimation (to include all available data) can be used to better detect treatment effects. This protocol takes 2 h to carry out.

  17. Nonlinear analysis of longitudinal-mode liquid propellant rocket combustion instability

    Science.gov (United States)

    Jeng, San-Mou; Litchford, Ron J.

    1991-01-01

    A computational technique for the nonlinear analysis of longitudinal-mode liquid propellant rocket combustion instability is examined based on the unsteady, quasi-one-dimensional Euler equations with appropriate source terms introduced to account for interphase transport coupling with the spray. The method is first assessed for unsteady, nonreacting, isentropic duct flow with specified admittances at the outflow and inflow boundaries. For small amplitude disturbances, numerical results based on a sufficient number of grid points compare favorably with predictions from a small-disturbance linearized analysis.

  18. Targeting pediatric versus elderly populations for norovirus vaccines: a model-based analysis of mass vaccination options

    Science.gov (United States)

    Steele, Molly K.; Remais, Justin V.; Gambhir, Manoj; Glasser, John W.; Handel, Andreas; Parashar, Umesh D.; Lopman, Benjamin A.

    2016-01-01

    Background Noroviruses are the leading cause of acute gastroenteritis and foodborne diarrheal disease in the United States. Norovirus vaccine development has progressed in recent years, but critical questions remain regarding which age groups should be vaccinated to maximize population impact. Methods We developed a deterministic, age-structured compartmental model of norovirus transmission and immunity in the U.S. population. The model was fit to age-specific monthly U.S. hospitalizations between 1996 and 2007. We simulated mass immunization of both pediatric and elderly populations assuming realistic coverages of 90% and 65%, respectively. We considered two mechanism of vaccine action, resulting in lower vaccine efficacy (lVE) between 22% and 43% and higher VE (hVE) of 50%. Results Pediatric vaccination was predicted to avert 33% (95% CI: 27%, 40%) and 60% (95% CI: 49%, 71%) of norovirus episodes among children under five years for lVE and hVE, respectively. Vaccinating the elderly averted 17% (95% CI: 12%, 20%) and 38% (95% CI: 34%, 42%) of cases in 65+ year olds for lVE and hVE, respectively. At a population level, pediatric vaccination was predicted to avert 18–21 times more cases and twice as many deaths per vaccinee compared to elderly vaccination. Conclusions The potential benefits are likely greater for a pediatric program, both via direct protection of vaccinated children and indirect protection of unvaccinated individuals, including adults and the elderly. These findings argue for a clinical development plan that will deliver a vaccine with a safety and efficacy profile suitable for use in children. PMID:27821278

  19. Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and meta-analysis.

    Science.gov (United States)

    Santos, Victor S; Marques, Daniella P; Martins-Filho, Paulo R S; Cuevas, Luis E; Gurgel, Ricardo Q

    2016-08-12

    Rotavirus was the leading cause of childhood diarrhoea-related hospitalisations and death before the introduction of rotavirus vaccines. We describe the effectiveness of rotavirus vaccines to prevent rotavirus infections and hospitalizations and the main rotavirus strains circulating before and after vaccine introduction through a systematic review and meta-analysis of studies published between 1990 and 2014. 203 studies were included to estimate the proportion of infections due to rotavirus and 10 to assess the impact of the vaccines. 41 of 46 studies in the post-vaccination period were used for meta-analysis of genotypes, 20 to calculate VE against infection, eight for VE against hospitalisation and seven for VE against severe rotavirus-diarrhoea. 24.3 % (95 % CI 22.1-26.5) and 16.1 % (95 % CI 13.2-19.3) of cases of diarrhoea were due to rotavirus before and after vaccine introduction, respectively. The most prevalent G types after vaccine introduction were G2 (51.6 %, 95 % CI 38-65), G9 (14.5 %, 95 % CI 7-23) and G1 (14.2 %, 95 % CI 7-23); while the most prevalent P types were P[4] (54.1 %, 95 % CI 41-67) and P[8] (33 %, 95 % CI 22-46). G2P[4] was the most frequent genotype combination after vaccine introduction. Effectiveness was 53 % (95 % CI 46-60) against infection, 73 % (95 % CI, 66-78) against hospitalisation and 74 % (95 % CI, 68.0-78.0) against severe diarrhoea. Reductions in hospitalisations and mortality due to diarrhoea were observed in countries that adopted universal rotavirus vaccination. Rotavirus vaccines are effective in preventing rotavirus-diarrhoea in children in Latin America. The vaccines were associated with changes in genotype distribution.

  20. Cost-effectiveness analysis of catch-up hepatitis A vaccination among unvaccinated/partially-vaccinated children.

    Science.gov (United States)

    Hankin-Wei, Abigail; Rein, David B; Hernandez-Romieu, Alfonso; Kennedy, Mallory J; Bulkow, Lisa; Rosenberg, Eli; Trigg, Monica; Nelson, Noele P

    2016-07-29

    Since 2006, the US Centers for Disease Control and Prevention has recommended hepatitis A (HepA) vaccination routinely for children aged 12-23months to prevent hepatitis A virus (HAV) infection. However, a substantial proportion of US children are unvaccinated and susceptible to infection. We present results of economic modeling to assess whether a one-time catch-up HepA vaccination recommendation would be cost-effective. We developed a Markov model of HAV infection that followed a single cohort from birth through death (birth to age 95years). The model compared the health and economic outcomes from catch-up vaccination interventions for children at target ages from two through 17years vs. outcomes resulting from maintaining the current recommendation of routine vaccination at age one year with no catch-up intervention. Over the lifetime of the cohort, catch-up vaccination would reduce the total number of infections relative to the baseline by 741 while increasing doses of vaccine by 556,989. Catch-up vaccination would increase net costs by $10.2million, or $2.38 per person. The incremental cost of HepA vaccine catch-up intervention at age 10years, the midpoint of the ages modeled, was $452,239 per QALY gained. Across age-cohorts, the cost-effectiveness of catch-up vaccination is most favorable at age 12years, resulting in an Incremental Cost-Effectiveness Ratio of $189,000 per QALY gained. Given the low baseline of HAV disease incidence achieved by current vaccination recommendations, our economic model suggests that a catch-up vaccination recommendation would be less cost-effective than many other vaccine interventions, and that HepA catch-up vaccination would become cost effective at a threshold of $50,000 per QALY only when incidence of HAV rises about 5.0 cases per 100,000 population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Methods and considerations for longitudinal structural brain imaging analysis across development

    Directory of Open Access Journals (Sweden)

    Kathryn L. Mills

    2014-07-01

    Full Text Available Magnetic resonance imaging (MRI has allowed the unprecedented capability to measure the human brain in vivo. This technique has paved the way for longitudinal studies exploring brain changes across the entire life span. Results from these studies have given us a glimpse into the remarkably extended and multifaceted development of our brain, converging with evidence from anatomical and histological studies. Ever-evolving techniques and analytical methods provide new avenues to explore and questions to consider, requiring researchers to balance excitement with caution. This review addresses what MRI studies of structural brain development in children and adolescents typically measure and how. We focus on measurements of brain morphometry (e.g., volume, cortical thickness, surface area, folding patterns, as well as measurements derived from diffusion tensor imaging (DTI. By integrating finding from multiple longitudinal investigations, we give an update on current knowledge of structural brain development and how it relates to other aspects of biological development and possible underlying physiological mechanisms. Further, we review and discuss current strategies in image processing, analysis techniques and modeling of brain development. We hope this review will aid current and future longitudinal investigations of brain development, as well as evoke a discussion amongst researchers regarding best practices.

  2. Bayesian Nonparametric Regression Analysis of Data with Random Effects Covariates from Longitudinal Measurements

    KAUST Repository

    Ryu, Duchwan

    2010-09-28

    We consider nonparametric regression analysis in a generalized linear model (GLM) framework for data with covariates that are the subject-specific random effects of longitudinal measurements. The usual assumption that the effects of the longitudinal covariate processes are linear in the GLM may be unrealistic and if this happens it can cast doubt on the inference of observed covariate effects. Allowing the regression functions to be unknown, we propose to apply Bayesian nonparametric methods including cubic smoothing splines or P-splines for the possible nonlinearity and use an additive model in this complex setting. To improve computational efficiency, we propose the use of data-augmentation schemes. The approach allows flexible covariance structures for the random effects and within-subject measurement errors of the longitudinal processes. The posterior model space is explored through a Markov chain Monte Carlo (MCMC) sampler. The proposed methods are illustrated and compared to other approaches, the "naive" approach and the regression calibration, via simulations and by an application that investigates the relationship between obesity in adulthood and childhood growth curves. © 2010, The International Biometric Society.

  3. Longitudinal in vivo muscle function analysis of the DMSXL mouse model of myotonic dystrophy type 1.

    Science.gov (United States)

    Decostre, Valérie; Vignaud, Alban; Matot, Béatrice; Huguet, Aline; Ledoux, Isabelle; Bertil, Emilie; Gjata, Bernard; Carlier, Pierre G; Gourdon, Geneviève; Hogrel, Jean-Yves

    2013-12-01

    Myotonic dystrophy is the most common adult muscle dystrophy. In view of emerging therapies, which use animal models as a proof of principle, the development of reliable outcome measures for in vivo longitudinal study of mouse skeletal muscle function is becoming crucial. To satisfy this need, we have developed a device to measure ankle dorsi- and plantarflexion torque in rodents. We present an in vivo 8-month longitudinal study of the contractile properties of the skeletal muscles of the DMSXL mouse model of myotonic dystrophy type 1. Between 4 and 12 months of age, we observed a reduction in muscle strength in the ankle dorsi- and plantarflexors of DMSXL compared to control mice although the strength per muscle cross-section was normal. Mild steady myotonia but no abnormal muscle fatigue was also observed in the DMSXL mice. Magnetic resonance imaging and histological analysis performed at the end of the study showed respectively reduced muscle cross-section area and smaller muscle fibre diameter in DMSXL mice. In conclusion, our study demonstrates the feasibility of carrying out longitudinal in vivo studies of muscle function over several months in a mouse model of myotonic dystrophy confirming the feasibility of this method to test preclinical therapeutics. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Analysis of the evidence on the efficacy and safety of CYD-TDV dengue vaccine and its potential licensing and implementation through Mexico´s Universal Vaccination Program

    Directory of Open Access Journals (Sweden)

    Mauricio Hernández-Ávila

    2016-01-01

    Full Text Available Dengue is a major global public health problem affecting Latin America and Mexico Prevention and control measures, focusing on epidemiological surveillance and vector control, have been partially effective and costly, thus, the development of a vaccine against dengue has created great expectations among health authorities and scientific communities worldwide. The CYD-TDV dengue vaccine produced by Sanofi-Pasteur is the only dengue vaccine evaluated in phase 3 controlled clinical trials. Notwithstanding the significant contribution to the development of a vaccine against dengue, the three phase 3 clinical studies of CYD-TDV and the meta-analysis of the long-term follow up of those studies, have provided evidence that this vaccine exhibited partial vaccine efficacy to protect against virologically confirmed dengue and lead to four considerations: a adequate vaccine efficacy against dengue virus (DENV infections 3 and 4, less vaccine efficacy against DENV 1 and no protection against infection by DENV 2; b decreased vaccine efficacy in dengue seronegative individuals at the beginning of the vaccination; c 83% and 90% protection against hospitalizations and severe forms of dengue, respectively, at 25 months follow-up; and d increased hospitalization for dengue in the vaccinated group, in children under nine years of age at the time of vaccination, detected since the third year of follow-up. The benefit of the CYD-TDV vaccine can be summarized in the protection against infection by DENV 3 and 4, as well as protection for hospitalizations and severe cases in people over nine years, who have had previous dengue infection, working mainly as a booster. In this review we identified elements on efficacy and safety of this vaccine that must be taken into account in the licensing process and potential inclusion in the national vaccination program of Mexico. The available scientific evidence on the CYD-TDV vaccine shows merits, but also leads to relevant

  5. Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination

    National Research Council Canada - National Science Library

    Lee, Donghoon; Park, Sang Min

    2016-01-01

    .... Methods To examine the cost-effectiveness of vaccination strategies to prevent perinatal transmission of HBV in North Korea, we established a decision tree with a Markov model consisting of selective...

  6. Economic analysis of vaccination to control bovine brucellosis in the States of Sao Paulo and Mato Grosso, Brazil.

    Science.gov (United States)

    Alves, A J S; Rocha, F; Amaku, M; Ferreira, F; Telles, E O; Grisi Filho, J H H; Ferreira Neto, J S; Zylbersztajn, D; Dias, R A

    2015-03-01

    Brucellosis is a zoonotic disease that causes important economic losses in Brazil, and the country has therefore established a national program for its control and eradication. Using data generated in the last national brucellosis survey, we conducted an economic analysis in two Brazilian States with different brucellosis status, Mato Grosso (with high prevalence) and Sao Paulo (with low prevalence). The economic analysis was based on the calculation of the additional benefits and costs of controlling bovine brucellosis through the vaccination of heifers aged between 3 and 8 months with S19 vaccine, considering maximal and minimal impacts of the disease. The analysis showed that vaccinating 90% of the replacement heifers aged 3-8 months of age offers the best economic performance in a vaccination program against bovine brucellosis if compared to vaccination rates of 70% and 80%. Moreover, regions with higher prevalences of bovine brucellosis would experience significant economic advantages when implementing a vaccination strategy to control the disease. This economic analysis will allow decision makers to plan more economically effective vaccination programs. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. HPV vaccine

    Science.gov (United States)

    Vaccine - HPV; Immunization - HPV; Gardasil; HPV2; HPV4; Vaccine to prevent cervical cancer; Genital warts - HPV vaccine; Cervical dysplasia - HPV vaccine; Cervical cancer - HPV vaccine; Cancer of the cervix - HPV vaccine; Abnormal ...

  8. Vaccinations and risk of systemic lupus erythematosus and rheumatoid arthritis: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Bin; Shao, Xiaoqing; Wang, Dan; Xu, Donghua; Zhang, Jin-An

    2017-07-01

    In the past several years, more and more studies proposed some concerns on the possibly increased risk of autoimmune diseases in individuals receiving vaccinations, but published studies on the associations of vaccinations with risks of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) reported conflicting findings. A systematic review and meta-analysis was carried out to comprehensively evaluate the relationship between vaccinations and risk of SLE and RA. Pubmed, Web of Science and Embase were searched for observational studies assessing the associations of vaccinations with risks of RA and SLE. Two authors independently extracted data from those eligible studies. The quality of eligible studies was assessed by using the Newcastle-Ottawa Scale (NOS). The pooled relative risk (RR) with 95% confidence intervals (CIs) was used to measure the risk of RA and SLE associated with vaccinations, and was calculated through random-effect meta-analysis. Sixteen observational studies were finally considered eligible, including 12 studies on the association between vaccinations and SLE risk and 13 studies on the association between vaccinations and RA risk. The pooled findings suggested that vaccinations significantly increased risk of SLE (RR=1.50; 95%CI 1.05-2.12, P=0.02). In addition, there was an obvious association between vaccinations and increased risk of RA (RR=1.32; 95%CI 1.09-1.60, P=0.004). Meta-analysis of studies reporting outcomes of short vaccinated time also suggested that vaccinations could significantly increase risk of SLE (RR=1.93; 95%CI 1.07-3.48, P=0.028) and RA (RR=1.48; 95%CI 1.08-2.03, P=0.015). Sensitivity analyses in studies with low risk of bias also found obvious associations of vaccinations with increased risk of RA and SLE. This study suggests that vaccinations are related to increased risks of SLE and RA. More and larger observational studies are needed to further verify the findings above and to assess the associations of

  9. Meta-analysis of the immunogenicity and tolerability of pandemic influenza A 2009 (H1N1 vaccines.

    Directory of Open Access Journals (Sweden)

    Lamberto Manzoli

    Full Text Available BACKGROUND: Although the 2009 (H1N1 influenza pandemic officially ended in August 2010, the virus will probably circulate in future years. Several types of H1N1 vaccines have been tested including various dosages and adjuvants, and meta-analysis is needed to identify the best formulation. METHODS: We searched MEDLINE, EMBASE, and nine clinical trial registries to April 2011, in any language for randomized clinical trials (RCTs on healthy children, adolescents, adults and the elderly. Primary outcome was the seroconversion rate according to hemagglutinination-inhibition (HI; secondary outcomes were adverse events. For the primary outcome, we used head-to-head meta-analysis and multiple-treatments meta-analysis. RESULTS: Eighteen RCTs could be included in all primary analyses, for a total of 76 arms (16,725 subjects. After 2 doses, all 2009 H1N1 split/subunit inactivated vaccines were highly immunogenic and overcome CPMP seroconversion criteria. After 1 dose only, all split/subunit vaccines induced a satisfactory immunogenicity (> = 70% in adults and adolescents, while only some formulations showed acceptable results for children and elderly (non-adjuvanted at high-doses and oil-in-water adjuvanted vaccines. Vaccines with oil-in-water adjuvants were more immunogenic than both nonadjuvanted and aluminum-adjuvanted vaccines at equal doses and their immunogenicity at doses < = 6 µg (even with as little as 1.875 µg of hemagglutinin antigen was not significantly lower than that achieved after higher doses. Finally, the rate of serious vaccine-related adverse events was low for all 2009 H1N1 vaccines (3 cases, resolved in 10 days, out of 22826 vaccinated subjects. However, mild to moderate adverse reactions were more (and very frequent for oil-in-water adjuvanted vaccines. CONCLUSIONS: Several one-dose formulations might be valid for future vaccines, but 2 doses may be needed for children, especially if a low-dose non-adjuvanted vaccine is

  10. Analysis of longitudinal data from animals where some data are missing in SPSS

    Science.gov (United States)

    Duricki, DA; Soleman, S; Moon, LDF

    2017-01-01

    Testing of therapies for disease or injury often involves analysis of longitudinal data from animals. Modern analytical methods have advantages over conventional methods (particularly where some data are missing) yet are not used widely by pre-clinical researchers. We provide here an easy to use protocol for analysing longitudinal data from animals and present a click-by-click guide for performing suitable analyses using the statistical package SPSS. We guide readers through analysis of a real-life data set obtained when testing a therapy for brain injury (stroke) in elderly rats. We show that repeated measures analysis of covariance failed to detect a treatment effect when a few data points were missing (due to animal drop-out) whereas analysis using an alternative method detected a beneficial effect of treatment; specifically, we demonstrate the superiority of linear models (with various covariance structures) analysed using Restricted Maximum Likelihood estimation (to include all available data). This protocol takes two hours to follow. PMID:27196723

  11. Increasing uptake of influenza vaccine by pregnant women post H1N1 pandemic: a longitudinal study in Melbourne, Australia, 2010 to 2014.

    Science.gov (United States)

    McCarthy, Elizabeth Anne; Pollock, Wendy Elizabeth; Tapper, Lauren; Sommerville, Maree; McDonald, Susan

    2015-03-05

    A Melbourne (Australia) university affiliated, tertiary obstetric hospital provides lay and professional education about influenza vaccine in pregnancy annually each March, early in the local influenza season. Responding to a 2011 survey of new mothers' opinions, the hospital made influenza vaccine freely available in antenatal clinics from 2012. We wished to determine influenza vaccination uptake during pregnancy with these strategies 5 years after 2009 H1N1. Face to face interviews based on US Center for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System with new mothers in postnatal wards each July, 2010 to 2014. We calculated recalled influenza vaccine uptake each year and assessed trends with chi square tests, and logistic regression. We recorded 1086 interviews. Influenza vaccination during pregnancy increased by 6% per year (95% confidence interval 4 to 8%): from 29.6% in 2010 to 51.3% in 2014 (p benefits are increasingly being heeded. However, there was progressively lower awareness of maternal benefits of influenza vaccination, especially for women with risk factors for severe disease. We observed improving influenza vaccination during pregnancy. There is potential to integrate technology such as text message or internet with antenatal consultations to increase vaccination coverage further.

  12. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France

    Science.gov (United States)

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Remi

    2013-01-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

  13. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France.

    Science.gov (United States)

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Rémi

    2013-04-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types.

  14. Genotype analysis of ORF 62 identifies varicella-zoster virus infections caused by a vaccine strain in children.

    Science.gov (United States)

    Kwak, Byung Ok; Lee, Hoan Jong; Kang, Hyun Mi; Oh, Chi Eun; Choi, Eun Hwa

    2017-06-01

    This study was performed to differentiate vaccine-type strains from wild-type strains and determine the genotype of varicella-zoster virus (VZV) in 51 Korean children. A sequencing analysis of ORF 62 identified two cases of herpes zoster caused by the vaccine-type virus, without a previous history of varicella, 22 months and 5 months after VZV vaccination. The wild-type strain was identified in the remaining children. A genotype analysis of ORF 22 amino acids revealed genotype J in all children except one. Genotype E was identified in an infant with varicella imported from Egypt.

  15. Psychosocial determinants of parental human papillomavirus (HPV vaccine decision-making for sons: Methodological challenges and initial results of a pan-Canadian longitudinal study

    Directory of Open Access Journals (Sweden)

    Samara Perez

    2016-12-01

    Full Text Available Abstract Background HPV vaccination decision-making is a complex process that is influenced by multiple psychosocial determinants. Given the change in policy recommendation to include males in routine HPV vaccination, our goals were to assess the HPV vaccination uptake in Canada, to understand where Canadian parents were situated in the HPV vaccine decision-making process for their son, how they changed over time and which psychosocial determinants were relevant for this process. Methods We used an online survey methodology and collected data from a nationally representative sample of Canadian parents of boys aged 9–16 at baseline (T1, February 2014 and at 9 months’ follow-up (T2. Our analyses were guided by the Precaution Adoption Process Model (PAPM, a theoretical health behavior model that classifies parents in one of six stages: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate and those who had already vaccinated their sons. Rigorous methods were used to filter out careless responders: response variance, bogus items, psychometric antonyms and psychometric synonyms. Results At T1 and T2, we received 3,784 and 1,608 respectively completed questionnaires; after data cleaning 3,117 (T1 and 1,427 (T2 were retained. Less than 3% of boys were vaccinated at both time points. At both T1 and T2, most parents (over 70% belonged to the earlier vaccination adoption stages: 57% were unaware (T1 and 15.3% (T2; 20.9% were unengaged (T1 and 32.4% (T2; and 9.1% were undecided (T1 and 25.2% (T2. At follow-up, 37.7% of participants did not move from their initial PAPM decision-making stage. Most parents (55% preferred to receive information from their healthcare provider (HCP but only 6% (T1 and 12% (T2 had actually spoken with a HCP about the HPV vaccine for their son. Conclusions HPV vaccination uptake in Canadian boys was very low in the absence of a publicly funded HPV vaccination programs for boys. Optimal HPV information

  16. Seasonal Influenza Vaccination amongst Medical Students: A Social Network Analysis Based on a Cross-Sectional Study: e0140085

    National Research Council Canada - National Science Library

    Rhiannon Edge; Joseph Heath; Barry Rowlingson; Thomas J Keegan; Rachel Isba

    2015-01-01

    .... Methods We used a social network analysis approach to look at vaccination distribution within the network of the Lancaster Medical School students and combined these data with the students' beliefs...

  17. Differential Adverse Event Profiles Associated with BCG as a Preventive Tuberculosis Vaccine or Therapeutic Bladder Cancer Vaccine Identified by Comparative Ontology-Based VAERS and Literature Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jiangan Xie

    Full Text Available M. bovis strain Bacillus Calmette-Guérin (BCG has been the only licensed live attenuated vaccine against tuberculosis (TB for nearly one century and has also been approved as a therapeutic vaccine for bladder cancer treatment since 1990. During its long time usage, different adverse events (AEs have been reported. However, the AEs associated with the BCG preventive TB vaccine and therapeutic cancer vaccine have not been systematically compared. In this study, we systematically collected various BCG AE data mined from the US VAERS database and PubMed literature reports, identified statistically significant BCG-associated AEs, and ontologically classified and compared these AEs related to these two types of BCG vaccine. From 397 VAERS BCG AE case reports, we identified 64 AEs statistically significantly associated with the BCG TB vaccine and 14 AEs with the BCG cancer vaccine. Our meta-analysis of 41 peer-reviewed journal reports identified 48 AEs associated with the BCG TB vaccine and 43 AEs associated with the BCG cancer vaccine. Among all identified AEs from VAERS and literature reports, 25 AEs belong to serious AEs. The Ontology of Adverse Events (OAE-based ontological hierarchical analysis indicated that the AEs associated with the BCG TB vaccine were enriched in immune system (e.g., lymphadenopathy and lymphadenitis, skin (e.g., skin ulceration and cyanosis, and respiratory system (e.g., cough and pneumonia; in contrast, the AEs associated with the BCG cancer vaccine mainly occurred in the urinary system (e.g., dysuria, pollakiuria, and hematuria. With these distinct AE profiles detected, this study also discovered three AEs (i.e., chills, pneumonia, and C-reactive protein increased shared by the BCG TB vaccine and bladder cancer vaccine. Furthermore, our deep investigation of 24 BCG-associated death cases from VAERS identified the important effects of age, vaccine co-administration, and immunosuppressive status on the final BCG

  18. Differential Adverse Event Profiles Associated with BCG as a Preventive Tuberculosis Vaccine or Therapeutic Bladder Cancer Vaccine Identified by Comparative Ontology-Based VAERS and Literature Meta-Analysis

    Science.gov (United States)

    Xie, Jiangan; Codd, Christopher; Mo, Kevin; He, Yongqun

    2016-01-01

    M. bovis strain Bacillus Calmette–Guérin (BCG) has been the only licensed live attenuated vaccine against tuberculosis (TB) for nearly one century and has also been approved as a therapeutic vaccine for bladder cancer treatment since 1990. During its long time usage, different adverse events (AEs) have been reported. However, the AEs associated with the BCG preventive TB vaccine and therapeutic cancer vaccine have not been systematically compared. In this study, we systematically collected various BCG AE data mined from the US VAERS database and PubMed literature reports, identified statistically significant BCG-associated AEs, and ontologically classified and compared these AEs related to these two types of BCG vaccine. From 397 VAERS BCG AE case reports, we identified 64 AEs statistically significantly associated with the BCG TB vaccine and 14 AEs with the BCG cancer vaccine. Our meta-analysis of 41 peer-reviewed journal reports identified 48 AEs associated with the BCG TB vaccine and 43 AEs associated with the BCG cancer vaccine. Among all identified AEs from VAERS and literature reports, 25 AEs belong to serious AEs. The Ontology of Adverse Events (OAE)-based ontological hierarchical analysis indicated that the AEs associated with the BCG TB vaccine were enriched in immune system (e.g., lymphadenopathy and lymphadenitis), skin (e.g., skin ulceration and cyanosis), and respiratory system (e.g., cough and pneumonia); in contrast, the AEs associated with the BCG cancer vaccine mainly occurred in the urinary system (e.g., dysuria, pollakiuria, and hematuria). With these distinct AE profiles detected, this study also discovered three AEs (i.e., chills, pneumonia, and C-reactive protein increased) shared by the BCG TB vaccine and bladder cancer vaccine. Furthermore, our deep investigation of 24 BCG-associated death cases from VAERS identified the important effects of age, vaccine co-administration, and immunosuppressive status on the final BCG-associated death

  19. Differential Adverse Event Profiles Associated with BCG as a Preventive Tuberculosis Vaccine or Therapeutic Bladder Cancer Vaccine Identified by Comparative Ontology-Based VAERS and Literature Meta-Analysis.

    Science.gov (United States)

    Xie, Jiangan; Codd, Christopher; Mo, Kevin; He, Yongqun

    2016-01-01

    M. bovis strain Bacillus Calmette-Guérin (BCG) has been the only licensed live attenuated vaccine against tuberculosis (TB) for nearly one century and has also been approved as a therapeutic vaccine for bladder cancer treatment since 1990. During its long time usage, different adverse events (AEs) have been reported. However, the AEs associated with the BCG preventive TB vaccine and therapeutic cancer vaccine have not been systematically compared. In this study, we systematically collected various BCG AE data mined from the US VAERS database and PubMed literature reports, identified statistically significant BCG-associated AEs, and ontologically classified and compared these AEs related to these two types of BCG vaccine. From 397 VAERS BCG AE case reports, we identified 64 AEs statistically significantly associated with the BCG TB vaccine and 14 AEs with the BCG cancer vaccine. Our meta-analysis of 41 peer-reviewed journal reports identified 48 AEs associated with the BCG TB vaccine and 43 AEs associated with the BCG cancer vaccine. Among all identified AEs from VAERS and literature reports, 25 AEs belong to serious AEs. The Ontology of Adverse Events (OAE)-based ontological hierarchical analysis indicated that the AEs associated with the BCG TB vaccine were enriched in immune system (e.g., lymphadenopathy and lymphadenitis), skin (e.g., skin ulceration and cyanosis), and respiratory system (e.g., cough and pneumonia); in contrast, the AEs associated with the BCG cancer vaccine mainly occurred in the urinary system (e.g., dysuria, pollakiuria, and hematuria). With these distinct AE profiles detected, this study also discovered three AEs (i.e., chills, pneumonia, and C-reactive protein increased) shared by the BCG TB vaccine and bladder cancer vaccine. Furthermore, our deep investigation of 24 BCG-associated death cases from VAERS identified the important effects of age, vaccine co-administration, and immunosuppressive status on the final BCG-associated death

  20. Clinical pharmacology quality assurance program: models for longitudinal analysis of antiretroviral proficiency testing for international laboratories.

    Science.gov (United States)

    DiFrancesco, Robin; Rosenkranz, Susan L; Taylor, Charlene R; Pande, Poonam G; Siminski, Suzanne M; Jenny, Richard W; Morse, Gene D

    2013-10-01

    Among National Institutes of Health HIV Research Networks conducting multicenter trials, samples from protocols that span several years are analyzed at multiple clinical pharmacology laboratories (CPLs) for multiple antiretrovirals. Drug assay data are, in turn, entered into study-specific data sets that are used for pharmacokinetic analyses, merged to conduct cross-protocol pharmacokinetic analysis, and integrated with pharmacogenomics research to investigate pharmacokinetic-pharmacogenetic associations. The CPLs participate in a semiannual proficiency testing (PT) program implemented by the Clinical Pharmacology Quality Assurance program. Using results from multiple PT rounds, longitudinal analyses of recovery are reflective of accuracy and precision within/across laboratories. The objectives of this longitudinal analysis of PT across multiple CPLs were to develop and test statistical models that longitudinally: (1) assess the precision and accuracy of concentrations reported by individual CPLs and (2) determine factors associated with round-specific and long-term assay accuracy, precision, and bias using a new regression model. A measure of absolute recovery is explored as a simultaneous measure of accuracy and precision. Overall, the analysis outcomes assured 97% accuracy (±20% of the final target concentration of all (21) drug concentration results reported for clinical trial samples by multiple CPLs). Using the Clinical Laboratory Improvement Act acceptance of meeting criteria for ≥2/3 consecutive rounds, all 10 laboratories that participated in 3 or more rounds per analyte maintained Clinical Laboratory Improvement Act proficiency. Significant associations were present between magnitude of error and CPL (Kruskal-Wallis P < 0.001) and antiretroviral (Kruskal-Wallis P < 0.001).

  1. Evaluation of cardiac dyssynchrony with longitudinal strain analysis in 4-chamber cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kawakubo, Masateru, E-mail: masateru@med.kyushu-u.ac.jp [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Kumazawa, Seiji, E-mail: s_kmzw@hs.med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Chishaki, Akiko S., E-mail: chishaki@hs.med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Mukai, Yasushi, E-mail: y_mukai@cardiol.med.kyushu-u.ac.jp [Department of Cardiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Nakamura, Yasuhiko, E-mail: yas-nkmr@r-tec.med.kyushu-u.ac.jp [Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan); Morishita, Junji, E-mail: junjim@med.kyushu-u.ac.jp [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku Fukuoka-city, Fukuoka 812-8582 (Japan)

    2013-12-01

    Purpose: We investigated the clinical performance of evaluation of cardiac mechanical dyssynchrony with longitudinal strain analysis using four-chamber (4CH) cine magnetic resonance imaging (MRI). Materials and methods: We retrospectively enrolled 73 chronic heart failure patients (41 men, 32 women; mean age, 57 years, NYHA 2, 3, and 4) who underwent a cardiac MRI in the present study. The left ventricular dyssynchrony (LVD) and interventricular dyssynchrony (IVD) indices were calculated by longitudinal strain analysis using 4CH cine MRI. The LVD and IVD indices were compared by the Wilcoxon rank-sum test between the patients with indication for cardiac resynchronization therapy (CRT) (n = 13) and without indication for CRT (n = 60), with LGE (n = 40) and without LGE (n = 27), the CRT responders (n = 8) and non-responders (n = 6), respectively. Results: LVD in the patients with indication for CRT were significantly longer than those without indication for CRT (LVD: 92 ± 65 vs. 28 ± 40 ms, P < .01). LVD and IVD were significantly longer in the patients with LGE than those without LGE (LVD: 54 ± 58 vs. 21 ± 30 ms, P < .01 and IVD: 51 ± 39 vs. 23 ± 34 ms, P < .01). LVD and IVD in the CRT responders were significantly longer than the CRT non-responders (LVD: 126 ± 55 vs. 62 ± 55 ms, P < .01 and IVD: 96 ± 39 vs. 52 ± 40 ms, P < .05). Conclusion: Longitudinal strain analysis with 4CH cine MRI could be useful for clinical examination in the evaluation of cardiac mechanical dyssynchrony.

  2. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.

    Science.gov (United States)

    Van Minh, Hoang; My, Nguyen Thi Tuyet; Jit, Mark

    2017-05-15

    Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. The cost of cervical cancer treatment ranged from US$368 - 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.

  3. Analysis of the protective immune response following intramuscular vaccination of calves against the intestinal parasite Cooperia oncophora.

    Science.gov (United States)

    Van Meulder, F; Ratman, D; Van Coppernolle, S; Borloo, J; Li, R W; Chiers, K; Van den Broeck, W; De Bosscher, K; Claerebout, E; Geldhof, P

    2015-08-01

    Recently we reported the successful vaccination of calves against Cooperia oncophora with a double domain activation-associated secreted protein, purified from the excretory-secretory material of adult stage parasites. In an attempt to elucidate the immune mechanisms involved in protection, the humoral and cell-mediated immune responses following vaccination and infection were compared with non-vaccinated control animals. Antigen-specific IgG1, IgG2 and IgA levels were significantly increased in sera of vaccinated animals post vaccination, whereas no effect was observed for IgM. Antigen-specific intestinal IgG1 levels were significantly increased in the vaccinated animals, whereas no differences were observed for antigen-specific IgA, IgM and IgG2 levels. Upon re-stimulation in vitro with the vaccine antigen, a significant proliferation of both αβ- and γδ-T cells, and B cells, collected from mesenteric lymph nodes, was only observed in vaccinated animals. RNA-seq analysis of intestinal tissue yielded a list of 67 genes that were differentially expressed in vaccinated animals following challenge infection, amongst which were several cell adhesion molecules, lectins and glycosyl transferases. A correlation analysis between all immunological and parasitological parameters indicated that intestinal anti-double domain activation-associated secreted protein IgG1 levels correlated negatively with cumulative faecal egg counts and positively with the proportion of L4s and L5s. The proportion of immature stages was also positively correlated with the proliferation of αβ T cells. Worm length was negatively correlated with the transcript levels of several lectins and cell adhesion molecules. Overall, the results indicate that intramuscular administration of the vaccine resulted in an immune memory response particularly characterised by increased antigen-specific IgG1 levels in the intestinal mucosa. Copyright © 2015 Australian Society for Parasitology Inc. Published by

  4. Quantitative Analysis of Repertoire-Scale Immunoglobulin Properties in Vaccine-Induced B-Cell Responses

    Directory of Open Access Journals (Sweden)

    Ilja V. Khavrutskii

    2017-08-01

    Full Text Available Recent advances in the next-generation sequencing of B-cell receptors (BCRs enable the characterization of humoral responses at a repertoire-wide scale and provide the capability for identifying unique features of immune repertoires in response to disease, vaccination, or infection. Immunosequencing now readily generates 103–105 sequences per sample; however, statistical analysis of these repertoires is challenging because of the high genetic diversity of BCRs and the elaborate clonal relationships among them. To date, most immunosequencing analyses have focused on reporting qualitative trends in immunoglobulin (Ig properties, such as usage or somatic hypermutation (SHM percentage of the Ig heavy chain variable (IGHV gene segment family, and on reducing complex Ig property distributions to simple summary statistics. However, because Ig properties are typically not normally distributed, any approach that fails to assess the distribution as a whole may be inadequate in (1 properly assessing the statistical significance of repertoire differences, (2 identifying how two repertoires differ, and (3 determining appropriate confidence intervals for assessing the size of the differences and their potential biological relevance. To address these issues, we have developed a technique that uses Wilcox’ robust statistics toolbox to identify statistically significant vaccine-specific differences between Ig repertoire properties. The advantage of this technique is that it can determine not only whether but also where the distributions differ, even when the Ig repertoire properties are non-normally distributed. We used this technique to characterize murine germinal center (GC B-cell repertoires in response to a complex Ebola virus-like particle (eVLP vaccine candidate with known protective efficacy. The eVLP-mediated GC B-cell responses were highly diverse, consisting of thousands of clonotypes. Despite this staggering diversity, we identified statistically

  5. Analysis of convective longitudinal fin with temperature-dependent thermal conductivity and internal heat generation

    Directory of Open Access Journals (Sweden)

    M.G. Sobamowo

    2017-03-01

    Full Text Available In this study, analysis of heat transfer in a longitudinal rectangular fin with temperature-dependent thermal conductivity and internal heat generation was carried out using finite difference method. The developed systems of non-linear equations that resulted from the discretization using finite difference scheme were solved with the aid of MATLAB using fsolve. The numerical solution was validated with the exact solution for the linear problem. The developed heat transfer models were used to investigate the effects of thermo-geometric parameters, coefficient of heat transfer and thermal conductivity (non-linear parameters on the temperature distribution, heat transfer and thermal performance of the longitudinal rectangular fin. From the results, it shows that the fin temperature distribution, the total heat transfer, and the fin efficiency are significantly affected by the thermo-geometric parameters of the fin. Also, for the solution to be thermally stable, the fin thermo-geometric parameter must not exceed a specific value. However, it was established that the increase in temperature-dependent properties and internal heat generation values increases the thermal stability range of the thermo-geometric parameter. The results obtained in this analysis serve as basis for comparison of any other method of analysis of the problem.

  6. Human papillomavirus vaccine efficacy in the prevention of anogenital warts: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Romina A Tejada

    2017-01-01

    Full Text Available Objective. To review evidence on the efficacy of HPV vaccines in the prevention of non-cancer lesions (anogenital warts [AGW], recurrent laryngeal papillomatosis and oral papillomatosis. Materials and methods. We conducted a systematic review of randomized trials. We performed random effect models and effects were reported as relative risks (RR and their confidence intervals (95%CI following both intention to treat (ITT and per protocol (PP analyses. Results. We included six studies (n=27 078. One study was rated as high risk of bias. One study could not be included in the meta-analysis because it provided combined results. We found that quadrivalent vaccine reduced the risk of AGW by 62% (RR: 0.38, 95%CI:0.32-0.45, I2:0% in the ITT analysis and by 95% (RR: 0.05, 95%CI:0.01-0.25, I2:66% in the PP analysis. Subgroup analyses of studies in women or with low-risk of bias provided similar results. Conclusion. HPV quadrivalent vaccine is efficacious in preventing AGW in men and women.

  7. Safety studies of aluminum in vaccines lack immunotoxicity analysis of this immunological adjuvant: Ignorance or deception?

    OpenAIRE

    Arumugham, Vinu

    2017-01-01

    The safety studies most often referred by vaccine regulators when making claims about the safety of aluminum in vaccines, have ignored the immunotoxicity of aluminum. Vaccinologists admit that they neither understand the general immunological mechanisms involved in vaccination nor do they understand the mechanisms involved in aluminum adjuvant action. Thus vaccine regulators have no scientific basis to make vaccine safety claims. Given this situation one would expect that vaccine regu...

  8. Meta-analysis on the efficacy of foot-and-mouth disease emergency vaccination

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Boklund, Anette; Cox, Sarah

    2011-01-01

    The objectives of this study were to provide a summary quantification of the efficacy of FMD emergency vaccination based on a systematic review and a meta-analysis of available literature, and to further discuss the suitability of this review and meta-analysis to summarize and further interpret...... of clinical signs including FMD lesions and fever, while the virological protection parameter was estimated based on the outcome of laboratory tests that were used to diagnose FMD infection. A meta-analysis relative risk was calculated per protection parameter. Results of the meta-analyses were examined using...

  9. Proteomic analysis of Mecistocirrus digitatus and Haemonchus contortus intestinal protein extracts and subsequent efficacy testing in a vaccine trial.

    Directory of Open Access Journals (Sweden)

    Alison J Dicker

    2014-06-01

    Full Text Available Gastrointestinal nematode infections, such as Haemonchus contortus and Mecistocirrus digitatus, are ranked in the top twenty diseases affecting small-holder farmers' livestock, yet research into M. digitatus, which infects cattle and buffalo in Asia is limited. Intestine-derived native protein vaccines are effective against Haemonchus, yet the protective efficacy of intestine-derived M. digitatus proteins has yet to be determined.A simplified protein extraction protocol (A is described and compared to an established method (B for protein extraction from H. contortus. Proteomic analysis of the H. contortus and M. digitatus protein extracts identified putative vaccine antigens including aminopeptidases (H11, zinc metallopeptidases, glutamate dehydrogenase, and apical gut membrane polyproteins. A vaccine trial compared the ability of the M. digitatus extract and two different H. contortus extracts to protect sheep against H. contortus challenge. Both Haemonchus fractions (A and B were highly effective, reducing cumulative Faecal Egg Counts (FEC by 99.19% and 99.89% and total worm burdens by 87.28% and 93.64% respectively, compared to the unvaccinated controls. There was no effect on H. contortus worm burdens following vaccination with the M. digitatus extract and the 28.2% reduction in cumulative FEC was not statistically significant. However, FEC were consistently lower in the M. digitatus extract vaccinates compared to the un-vaccinated controls from 25 days post-infection.Similar, antigenically cross-reactive proteins are found in H. contortus and M. digitatus; this is the first step towards developing a multivalent native vaccine against Haemonchus species and M. digitatus. The simplified protein extraction method could form the basis for a locally produced vaccine against H. contortus and, possibly M. digitatus, in regions where effective cold chains for vaccine distribution are limited. The application of such a vaccine in these regions would

  10. Routine Pediatric Enterovirus 71 Vaccination in China: a Cost-Effectiveness Analysis

    Science.gov (United States)

    Leung, Kathy; Xing, Weijia; Yang, Juan; Liao, Qiaohong; Cowling, Benjamin J.; Yang, Bingyi; Lau, Eric H. Y.; Takahashi, Saki; Farrar, Jeremy J.; Grenfell, Bryan T.; Leung, Gabriel M.; Yu, Hongjie

    2016-01-01

    Background China accounted for 87% (9.8 million/11.3 million) of all hand, foot, and mouth disease (HFMD) cases reported to WHO during 2010–2014. Enterovirus 71 (EV71) is responsible for most of the severe HFMD cases. Three EV71 vaccines recently demonstrated good efficacy in children aged 6–71 mo. Here we assessed the cost-effectiveness of routine pediatric EV71 vaccination in China. Methods and Findings We characterized the economic and health burden of EV71-associated HFMD (EV71-HFMD) in China using (i) the national surveillance database, (ii) virological surveillance records from all provinces, and (iii) a caregiver survey on the household costs and health utility loss for 1,787 laboratory-confirmed pediatric cases. Using a static model parameterized with these data, we estimated the effective vaccine cost (EVC, defined as cost/efficacy or simply the cost of a 100% efficacious vaccine) below which routine pediatric vaccination would be considered cost-effective. We performed the base-case analysis from the societal perspective with a willingness-to-pay threshold of one times the gross domestic product per capita (GDPpc) and an annual discount rate of 3%. We performed uncertainty analysis by (i) accounting for the uncertainty in the risk of EV71-HFMD due to missing laboratory data in the national database, (ii) excluding productivity loss of parents and caregivers, (iii) increasing the willingness-to-pay threshold to three times GDPpc, (iv) increasing the discount rate to 6%, and (v) accounting for the proportion of EV71-HFMD cases not registered by national surveillance. In each of these scenarios, we performed probabilistic sensitivity analysis to account for parametric uncertainty in our estimates of the risk of EV71-HFMD and the expected costs and health utility loss due to EV71-HFMD. Routine pediatric EV71 vaccination would be cost-saving if the all-inclusive EVC is below US$10.6 (95% CI US$9.7–US$11.5) and would remain cost-effective if EVC is below

  11. Routine Pediatric Enterovirus 71 Vaccination in China: a Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Joseph T Wu

    2016-03-01

    Full Text Available China accounted for 87% (9.8 million/11.3 million of all hand, foot, and mouth disease (HFMD cases reported to WHO during 2010-2014. Enterovirus 71 (EV71 is responsible for most of the severe HFMD cases. Three EV71 vaccines recently demonstrated good efficacy in children aged 6-71 mo. Here we assessed the cost-effectiveness of routine pediatric EV71 vaccination in China.We characterized the economic and health burden of EV71-associated HFMD (EV71-HFMD in China using (i the national surveillance database, (ii virological surveillance records from all provinces, and (iii a caregiver survey on the household costs and health utility loss for 1,787 laboratory-confirmed pediatric cases. Using a static model parameterized with these data, we estimated the effective vaccine cost (EVC, defined as cost/efficacy or simply the cost of a 100% efficacious vaccine below which routine pediatric vaccination would be considered cost-effective. We performed the base-case analysis from the societal perspective with a willingness-to-pay threshold of one times the gross domestic product per capita (GDPpc and an annual discount rate of 3%. We performed uncertainty analysis by (i accounting for the uncertainty in the risk of EV71-HFMD due to missing laboratory data in the national database, (ii excluding productivity loss of parents and caregivers, (iii increasing the willingness-to-pay threshold to three times GDPpc, (iv increasing the discount rate to 6%, and (v accounting for the proportion of EV71-HFMD cases not registered by national surveillance. In each of these scenarios, we performed probabilistic sensitivity analysis to account for parametric uncertainty in our estimates of the risk of EV71-HFMD and the expected costs and health utility loss due to EV71-HFMD. Routine pediatric EV71 vaccination would be cost-saving if the all-inclusive EVC is below US$10.6 (95% CI US$9.7-US$11.5 and would remain cost-effective if EVC is below US$17.9 (95% CI US$16.9-US$18.8 in

  12. Two-level mixed modeling of longitudinal pedigree data for genetic association analysis

    DEFF Research Database (Denmark)

    Tan, Q.

    2013-01-01

    Genetic association analysis on complex phenotypes under a longitudinal design involving pedigrees encounters the problem of correlation within pedigrees which could affect statistical assessment of the genetic effects on both the mean level of the phenotype and its rate of change over the time o....... Our results show that the method efficiently handles relatedness in detecting genetic variations that affect the mean level or the rate of change for a phenotype of interest.......Genetic association analysis on complex phenotypes under a longitudinal design involving pedigrees encounters the problem of correlation within pedigrees which could affect statistical assessment of the genetic effects on both the mean level of the phenotype and its rate of change over the time...... modeling of genetic effects on the mean level of a phenotype, current algorithms implemented in popular statistical packages are not so straightforward to handle the kinship correlation on the time-dependent trajectories of a phenotype. We introduce a two-level hierarchical linear model to separately...

  13. Error Estimates of the Ares I Computed Turbulent Ascent Longitudinal Aerodynamic Analysis

    Science.gov (United States)

    Abdol-Hamid, Khaled S.; Ghaffari, Farhad

    2012-01-01

    Numerical predictions of the longitudinal aerodynamic characteristics for the Ares I class of vehicles, along with the associated error estimate derived from an iterative convergence grid refinement, are presented. Computational results are based on an unstructured grid, Reynolds-averaged Navier-Stokes analysis. The validity of the approach to compute the associated error estimates, derived from a base grid to an extrapolated infinite-size grid, was first demonstrated on a sub-scaled wind tunnel model at representative ascent flow conditions for which the experimental data existed. Such analysis at the transonic flow conditions revealed a maximum deviation of about 23% between the computed longitudinal aerodynamic coefficients with the base grid and the measured data across the entire roll angles. This maximum deviation from the wind tunnel data was associated with the computed normal force coefficient at the transonic flow condition and was reduced to approximately 16% based on the infinite-size grid. However, all the computed aerodynamic coefficients with the base grid at the supersonic flow conditions showed a maximum deviation of only about 8% with that level being improved to approximately 5% for the infinite-size grid. The results and the error estimates based on the established procedure are also presented for the flight flow conditions.

  14. Micro-Mechanical Analysis About Kink Band in Carbon Fiber/Epoxy Composites Under Longitudinal Compression

    Science.gov (United States)

    Zhang, Mi; Guan, Zhidong; Wang, Xiaodong; Du, Shanyi

    2017-10-01

    Kink band is a typical phenomenon for composites under longitudinal compression. In this paper, theoretical analysis and finite element simulation were conducted to analyze kink angle as well as compressive strength of composites. Kink angle was considered to be an important character throughout longitudinal compression process. Three factors including plastic matrix, initial fiber misalignment and rotation due to loading were considered for theoretical analysis. Besides, the relationship between kink angle and fiber volume fraction was improved and optimized by theoretical derivation. In addition, finite element models considering fiber stochastic strength and Drucker-Prager constitutive model for matrix were conducted in ABAQUS to analyze kink band formation process, which corresponded with the experimental results. Through simulation, the loading and failure procedure can be evidently divided into three stages: elastic stage, softening stage, and fiber break stage. It also shows that kink band is a result of fiber misalignment and plastic matrix. Different values of initial fiber misalignment angle, wavelength and fiber volume fraction were considered to explore the effects on compressive strength and kink angle. Results show that compressive strength increases with the decreasing of initial fiber misalignment angle, the decreasing of initial fiber misalignment wavelength and the increasing of fiber volume fraction, while kink angle decreases in these situations. Orthogonal array in statistics was also built to distinguish the effect degree of these factors. It indicates that initial fiber misalignment angle has the largest impact on compressive strength and kink angle.

  15. Improvement or selection? A longitudinal analysis of students' views about experimental physics in their lab courses

    Science.gov (United States)

    Wilcox, Bethany R.; Lewandowski, H. J.

    2017-12-01

    Laboratory courses represent a unique and potentially important component of the undergraduate physics curriculum, which can be designed to allow students to authentically engage with the process of experimental physics. Among other possible benefits, participation in these courses throughout the undergraduate physics curriculum presents an opportunity to develop students' understanding of the nature and importance of experimental physics within the discipline as a whole. Here, we present and compare both a longitudinal and pseudolongitudinal analysis of students' responses to a research-based assessment targeting students' views about experimental physics—the Colorado Learning Attitudes about Science Survey for Experimental Physics (E-CLASS)—across multiple, required lab courses at a single institution. We find that, while pseudolongitudinal averages showed increases in students' E-CLASS scores in each consecutive course, analysis of longitudinal data indicates that this increase was not driven by a cumulative impact of laboratory instruction. Rather, the increase was driven by a selection effect in which students who persisted into higher-level lab courses already had more expertlike beliefs, attitudes, and expectations than their peers when they started the lower-level courses.

  16. Longitudinal, transverse, and single-particle dynamics in liquid Zn: Ab initio study and theoretical analysis

    Science.gov (United States)

    del Rio, B. G.; González, L. E.

    2017-06-01

    We perform ab initio molecular dynamics simulations of liquid Zn near the melting point in order to study the longitudinal and transverse dynamic properties of the system. We find two propagating excitations in both of them in a wide range of wave vectors. This is in agreement with some experimental observations of the dynamic structure factor in the region around half the position of the main peak. Moreover, the two-mode structure in the transverse and longitudinal current correlation functions had also been previously observed in high pressure liquid metallic systems. We perform a theoretical analysis in order to investigate the possible origin of such two components by resorting to mode-coupling theories. They are found to describe qualitatively the appearance of two modes in the dynamics, but their relative intensities are not quantitatively reproduced. We suggest some possible improvements of the theory through the analysis of the structure of the memory functions. We also analyze the single-particle dynamics embedded in the velocity autocorrelation function, and explain its characteristics through mode-coupling concepts.

  17. Genome-wide meta-analysis of longitudinal alcohol consumption across youth and early adulthood

    Science.gov (United States)

    Adkins, Daniel E.; Clark, Shaunna L.; Copeland, William E.; Kennedy, Martin; Conway, Kevin; Angold, Adrian; Maes, Hermine; Liu, Youfang; Kumar, Gaurav; Erkanli, Alaattin; Patkar, Ashwin A.; Silberg, Judy; Brown, Tyson H.; Fergusson, David M.; Horwood, L. John; Eaves, Lindon; van den Oord, Edwin J.C.G.; Sullivan, Patrick F.; Costello, E. J.

    2016-01-01

    The public health burden of alcohol is unevenly distributed across the life course, with levels of use, abuse and dependence increasing across adolescence and peaking in early adulthood. Here we leverage this temporal patterning to search for common genetic variants predicting developmental trajectories of alcohol consumption. Comparable psychiatric evaluations measuring alcohol consumption were collected in three, longitudinal community samples (N=2,126, obs=12,166). Consumption repeated measurements spanning adolescence and early adulthood were analyzed using linear mixed models, estimating individual consumption trajectories, which were then tested for association with Illumina 660W-Quad genotype data (866,099 SNPs after imputation and QC). Association results were combined across samples using standard meta-analysis methods. Four meta-analysis associations satisfied our pre-determined genome-wide significance criterion (FDR<0.1) and 6 others met our “suggestive” criterion (FDR<0.2). Genome-wide significant associations were highly biological plausible, including associations within GABA transporter 1, SLC6A1 (solute carrier family 6, member 1), and exonic hits in LOC100129340 (mitofusin-1-like). Pathway analyses elaborated single marker results, indicating significant enriched associations to intuitive biological mechanisms including neurotransmission, xenobiotic pharmacodynamics and nuclear hormone receptors. These findings underscore the value of combining longitudinal behavioral data and genome-wide genotype information in order to study developmental patterns and improve statistical power in genomic studies. PMID:26081443

  18. In Silico Analysis of Epitope-Based Vaccine Candidates against Hepatitis B Virus Polymerase Protein.

    Science.gov (United States)

    Zheng, Juzeng; Lin, Xianfan; Wang, Xiuyan; Zheng, Liyu; Lan, Songsong; Jin, Sisi; Ou, Zhanfan; Wu, Jinming

    2017-05-16

    Hepatitis B virus (HBV) infection has persisted as a major public health problem due to the lack of an effective treatment for those chronically infected. Therapeutic vaccination holds promise, and targeting HBV polymerase is pivotal for viral eradication. In this research, a computational approach was employed to predict suitable HBV polymerase targeting multi-peptides for vaccine candidate selection. We then performed in-depth computational analysis to evaluate the predicted epitopes' immunogenicity, conservation, population coverage, and toxicity. Lastly, molecular docking and MHC-peptide complex stabilization assay were utilized to determine the binding energy and affinity of epitopes to the HLA-A0201 molecule. Criteria-based analysis provided four predicted epitopes, RVTGGVFLV, VSIPWTHKV, YMDDVVLGA and HLYSHPIIL. Assay results indicated the lowest binding energy and high affinity to the HLA-A0201 molecule for epitopes VSIPWTHKV and YMDDVVLGA and epitopes RVTGGVFLV and VSIPWTHKV, respectively. Regions 307 to 320 and 377 to 387 were considered to have the highest probability to be involved in B cell epitopes. The T cell and B cell epitopes identified in this study are promising targets for an epitope-focused, peptide-based HBV vaccine, and provide insight into HBV-induced immune response.

  19. [Analysis of the Cochrane Review: Influenza Vaccines for Preventing Cardiovascular Disease. Cochrane Database Syst Rev. 2015;5:CD005050].

    Science.gov (United States)

    Caldeira, Daniel; Costa, João; Vaz-Carneiro, António

    2015-01-01

    Influenza infections are associated to increased risk of cardiovascular events. The systematic review of Cochrane Collaboration evaluated the role of influenza vaccination on primary or secondary prevention of cardiovascular events. The meta-analysis of four randomized controlled trials with moderate quality, including 1 682 patients with coronary artery disease, showed a 55% risk reduction on cardiovascular mortality. Data evaluating the role of vaccination in primary cardiovascular prevention were not robust. Portuguese and international recommendations for influenza vaccination in patients with coronary artery disease are then supported by this systematic review.

  20. Challenges and solutions during analysis in a longitudinal narrative case study.

    Science.gov (United States)

    Whiffin, Charlotte Jane; Bailey, Chris; Ellis-Hill, Caroline; Jarrett, Nikki

    2014-03-01

    To describe the challenges faced by those performing complex qualitative analysis during a narrative study and to offer solutions. Qualitative research requires rigorous analysis. However, novice researchers often struggle to identify appropriately robust analytical procedures that will move them from their transcripts to their final findings. The lack of clear and detailed accounts in the literature that consider narrative analysis and how to address some of the common challenges researchers face add to this problem. A longitudinal narrative case study exploring the personal and familial changes reported by uninjured family members during the first year of another family member's traumatic brain injury. Review methods This is a methodological paper. The challenges of analysis included: conceptualising analysis; demonstrating the relationship between the different analytical layers and the final research findings; interpreting the data in a way that reflected the priorities of a narrative approach; and managing large quantities of data. The solutions explored were: the mapping of analytic intentions; aligning analysis and interpretation with the conceptual framework; and the use of matrices to store and manage quotes, codes and reflections. Working with qualitative data can be daunting for novice researchers. Ensuring rigorous, transparent, and auditable data analysis procedures can further constrain the interpretive aspect of analysis. Implications for research/practice The solutions offered in this paper should help novice researchers to manage and work with their data, assisting them to develop the confidence to be more intuitive and creative in their research.

  1. A longitudinal study on determinants of HPV vaccination uptake in parents/guardians from different ethnic backgrounds in Amsterdam, the Netherlands.

    Science.gov (United States)

    Alberts, Catharina J; van der Loeff, Maarten F Schim; Hazeveld, Yvonne; de Melker, Hester E; van der Wal, Marcel F; Nielen, Astrid; El Fakiri, Fatima; Prins, Maria; Paulussen, Theo G W M

    2017-02-21

    Human papillomavirus (HPV) vaccination coverage in the Netherlands is low (~60%) compared to other childhood vaccinations (>90%), and even lower among ethnic minorities. The aim of this study was to explore the possible impact of ethnicity on the determinants of both HPV vaccination intention and HPV vaccination uptake among parents/guardians having a daughter that is invited for the HPV vaccination. In February 2014, parents/guardians living in Amsterdam were invited to complete a questionnaire about social-psychological determinants of their decision making process regarding the HPV vaccination of their daughter and socio-demographic characteristics. This questionnaire was sent approximately one month before the daughter was scheduled to receive her first HPV vaccine dose. Their daughters' HPV vaccination status was retrieved from the national vaccination database. We distinguished four ethnic groups: Dutch (NL), Surinamese, Netherlands Antillean, and Aruban (SNA), Middle-Eastern and North-African (MENA), and Other. To assess the impact of determinants on both intention and uptake, linear and logistic regression analyses were used respectively. Missing data were imputed using multiple imputation by chained equation. In total 1,309 parents/guardians participated (33% participation rate). In all groups we found the mothers' intention to be the strongest predictor of their daughters' HPV vaccination uptake. Explained variance of uptake was highest in the NL-group (pseudo-R2:0.56) and lower in the other ethnic groups (pseudo-R2 varied between 0.23 and 0.29). The lower explained variance can be attributed to the relative large proportion of participants with a positive intention that finally did not go for vaccination in the SNA-group (11%) and MENA-group (30%). Explained variance (R2) of intention varied between 0.66 and 0.77 across ethnic groups, and was best explained by the proximal social-psychological determinants. The strength of association of these

  2. Non-linear mixed models in the analysis of mediated longitudinal data with binary outcomes

    Science.gov (United States)

    2012-01-01

    Background Structural equation models (SEMs) provide a general framework for analyzing mediated longitudinal data. However when interest is in the total effect (i.e. direct plus indirect) of a predictor on the binary outcome, alternative statistical techniques such as non-linear mixed models (NLMM) may be preferable, particularly if specific causal pathways are not hypothesized or specialized SEM software is not readily available. The purpose of this paper is to evaluate the performance of the NLMM in a setting where the SEM is presumed optimal. Methods We performed a simulation study to assess the performance of NLMMs relative to SEMs with respect to bias, coverage probability, and power in the analysis of mediated binary longitudinal outcomes. Both logistic and probit models were evaluated. Models were also applied to data from a longitudinal study assessing the impact of alcohol consumption on HIV disease progression. Results For the logistic model, the NLMM adequately estimated the total effect of a repeated predictor on the repeated binary outcome and were similar to the SEM across a variety of scenarios evaluating sample size, effect size, and distributions of direct vs. indirect effects. For the probit model, the NLMM adequately estimated the total effect of the repeated predictor, however, the probit SEM overestimated effects. Conclusions Both logistic and probit NLMMs performed well relative to corresponding SEMs with respect to bias, coverage probability and power. In addition, in the probit setting, the NLMM may produce better estimates of the total effect than the probit SEM, which appeared to overestimate effects. PMID:22273051

  3. Differentiation between Vaccinal and Iranian Virulent Isolates of Newcastle Disease Virus based on F Region Genotyping by HRM Analysis

    OpenAIRE

    Shahdad Dibazar; Nariman Sheikhi; Farhid Hemmatzadeh; Saeed Charkhkar; Seyed Ali Pourbakhsh

    2014-01-01

    The purpose of this study is investigate Differentiation Between Vaccinal and Iranian Virulent Isolates of Newcastle Disease Virus based on F Region Genotyping by HRM Analysis. Discrimination of circulating virulent strains of Newcastle Disease Virus (NDV) from low pathogenic and vaccine stains is the basis for implementation of strategies to control and eradication of that aims at the eradication of NDV in poultry. At the present study the applicability of Real time RT-PCR followed High-Reso...

  4. Chinese immigrant parents' vaccination decision making for children: a qualitative analysis.

    Science.gov (United States)

    Wang, Linda D L; Lam, Wendy W T; Wu, Joseph T; Liao, Qiuyan; Fielding, Richard

    2014-02-07

    While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making. Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach. Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents. Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme.

  5. Global optimal vaccination in the SIR model: properties of the value function and application to cost-effectiveness analysis.

    Science.gov (United States)

    Laguzet, Laetitia; Turinici, Gabriel

    2015-05-01

    This work focuses on optimal vaccination policies for an Susceptible-Infected-Recovered (SIR) model; the impact of the disease is minimized with respect to the vaccination strategy. The problem is formulated as an optimal control problem and we show that the value function is the unique viscosity solution of an Hamilton-Jacobi-Bellman (HJB) equation. This allows to find the best vaccination policy. At odds with existing literature, it is seen that the value function is not always smooth (sometimes only Lipschitz) and the optimal vaccination policies are not unique. Moreover we rigorously analyze the situation when vaccination can be modeled as instantaneous (with respect to the time evolution of the epidemic) and identify the global optimum solutions. Numerical applications illustrate the theoretical results. In addition the pertussis vaccination in adults is considered from two perspectives: first the maximization of DALY averted in presence of vaccine side-effects; then the impact of the herd immunity on the cost-effectiveness analysis is discussed on a concrete example. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Analysis of impact of longitudinal inclination of a chain conveyor on dynamical phenomena during operation

    Directory of Open Access Journals (Sweden)

    Szewerda Kamil

    2017-01-01

    Full Text Available Armoured face conveyors (AFCs of length even up to 500 meters are used in coal mines for transportation of run-of-mine. The method of their installation depends on the geological and mining conditions and on a coal seam position. Operation of AFC in a horizontal or inclined position is allowed. The maximum accepted inclination is determined by the machine manufacturer. Two directions of longitudinal inclination of the conveyor have to be considered: upward and downward transportation of excavated material. Both the angle and the direction of inclination of the conveyor have a significant impact on the dynamics of its operation. Change in inclination of AFC results in tension of the chain. Loosening the scraper chain can lead to blockage, what can be a reason of damage. Excessive chain tension results in speeding up frictional wear of conveyor components. Determination of an impact of longitudinal inclination of the conveyor on a degree and a place of loosening or excessive tension of the chain was the objective of the numerical analyses, the results of which are presented. Analysis were performed using the developed numerical model of the Rybnik 850 conveyor. These analyses are a part of the preparatory work aiming at development of the control algorithm of AFC, to prevent the formation of unfavorable dynamic effects during the conveyor operation.

  7. Exposure to violent video games and aggression in German adolescents: a longitudinal analysis.

    Science.gov (United States)

    Möller, Ingrid; Krahé, Barbara

    2009-01-01

    The relationship between exposure to violent electronic games and aggressive cognitions and behavior was examined in a longitudinal study. A total of 295 German adolescents completed the measures of violent video game usage, endorsement of aggressive norms, hostile attribution bias, and physical as well as indirect/relational aggression cross-sectionally, and a subsample of N=143 was measured again 30 months later. Cross-sectional results at T1 showed a direct relationship between violent game usage and aggressive norms, and an indirect link to hostile attribution bias through aggressive norms. In combination, exposure to game violence, normative beliefs, and hostile attribution bias predicted physical and indirect/relational aggression. Longitudinal analyses using path analysis showed that violence exposure at T1 predicted physical (but not indirect/relational) aggression 30 months later, whereas aggression at T1 was unrelated to later video game use. Exposure to violent games at T1 influenced physical (but not indirect/relational) aggression at T2 via an increase of aggressive norms and hostile attribution bias. The findings are discussed in relation to social-cognitive explanations of long-term effects of media violence on aggression. Copyright 2008 Wiley-Liss, Inc.

  8. The Longitudinal Process of Early Parent Involvement on Student Achievement: A Path Analysis.

    Science.gov (United States)

    Hayakawa, Momoko; Englund, Michelle M; Warner-Richter, Mallory N; Reynolds, Arthur J

    2013-01-01

    This longitudinal study investigated the process whereby early parent involvement in preschool effects student achievement from kindergarten through 6(th) grade. Participants were 1,539 low-income, mainly African American children and their mothers, in the Chicago Longitudinal Study. Program children (N = 989) received one or two years of the Child-Parent Center (CPC) program - a preschool intervention that strongly promoted parents' development of parent involvement skills within the school and at home. Children from similar backgrounds who did not attend the CPC, but participated in available local resources (e.g. day care), were obtained as a comparison group (N = 550). Path analysis revealed an interactive process between parent involvement, academic achievement, and children's motivation. Early parent involvement directly influenced kindergarten achievement, which in turn influenced first grade student motivation. Highly motivated children then encouraged parents to continue involvement. The cyclic nature of this process across elementary school was observed. The model accounted for 61% of the variance in 6(th) grade achievement. Findings suggest that early parent involvement promoted in the CPC program, sets the stage for subsequent parent involvement, student motivation, and academic achievement throughout early and middle childhood.

  9. Negative Cognition, Depressed Mood, and Paranoia: A Longitudinal Pathway Analysis Using Structural Equation Modeling

    Science.gov (United States)

    Fowler, David; Hodgekins, Joanne; Garety, Philippa; Freeman, Daniel; Kuipers, Elizabeth; Dunn, Graham; Smith, Ben; Bebbington, Paul E.

    2012-01-01

    The role of negative cognition and effect in maintaining psychotic symptoms is increasingly recognized but has yet to be substantiated though longitudinal analysis. Based on an a priori theoretical model, we hypothesized that negative cognition and depressed mood play a direct causal role in maintaining paranoia in people with psychosis and that the effect of mood is mediated by negative cognition. We used data from the 301 patients in the Prevention of Relapse in Psychosis Trial of cognitive behavior therapy. They were recruited from consecutive Community Mental Health Team clients presenting with a recent relapse of psychosis. The teams were located in inner and outer London and the rural county of Norfolk, England. The study followed a longitudinal cohort design, with initial measures repeated at 3 and 12 months. Structural equation modeling was used to investigate the direction of effect between negative cognition, depressed mood, and paranoia. Overall fit was ambiguous in some analyses and confounding by unidentified variables cannot be ruled out. Nevertheless, the most plausible models were those incorporating pathways from negative cognition and depressed mood to paranoid symptoms: There was no evidence whatsoever for pathways in the reverse direction. The link between depressed mood and paranoia appeared to be mediated by negative cognition. Our hypotheses were thus corroborated. This study provides evidence for the role of negative cognition in the maintenance of paranoia, a role of central relevance, both to the design of psychological interventions and to the conceptualizations of psychosis. PMID:21474550

  10. Volumetric reconstruction from printed films: Enabling 30 year longitudinal analysis in MR neuroimaging.

    Science.gov (United States)

    Ebner, Michael; Chung, Karen K; Prados, Ferran; Cardoso, M Jorge; Chard, Declan T; Vercauteren, Tom; Ourselin, Sébastien

    2018-01-15

    Hospitals often hold historical MR image data printed on films without being able to make it accessible to modern image processing techniques. Having the possibility to recover geometrically consistent, volumetric images from scans acquired decades ago will enable more comprehensive, longitudinal studies to understand disease progressions. In this paper, we propose a consistent framework to reconstruct a volumetric representation from printed films holding thick single-slice brain MR image acquisitions dating back to the 1980's. We introduce a flexible framework based on semi-automatic slice extraction, followed by automated slice-to-volume registration with inter-slice transformation regularisation and slice intensity correction. Our algorithm is robust against numerous detrimental effects being present in archaic films. A subsequent, isotropic total variation deconvolution technique revitalises the visual appearance of the obtained volumes. We assess the accuracy and perform the validation of our reconstruction framework on a uniquely long-term MRI dataset where a ground-truth is available. This method will be used to facilitate a robust longitudinal analysis spanning 30 years of MRI scans. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Drug awareness in adolescents attending a mental health service: analysis of longitudinal data.

    Science.gov (United States)

    Arnau, Jaume; Bono, Roser; Díaz, Rosa; Goti, Javier

    2011-11-01

    One of the procedures used most recently with longitudinal data is linear mixed models. In the context of health research the increasing number of studies that now use these models bears witness to the growing interest in this type of analysis. This paper describes the application of linear mixed models to a longitudinal study of a sample of Spanish adolescents attending a mental health service, the aim being to investigate their knowledge about the consumption of alcohol and other drugs. More specifically, the main objective was to compare the efficacy of a motivational interviewing programme with a standard approach to drug awareness. The models used to analyse the overall indicator of drug awareness were as follows: (a) unconditional linear growth curve model; (b) growth model with subject-associated variables; and (c) individual curve model with predictive variables. The results showed that awareness increased over time and that the variable 'schooling years' explained part of the between-subjects variation. The effect of motivational interviewing was also significant.

  12. Social Activity and Cognitive Functioning Over Time: A Coordinated Analysis of Four Longitudinal Studies

    Directory of Open Access Journals (Sweden)

    Cassandra L. Brown

    2012-01-01

    Full Text Available Social activity is typically viewed as part of an engaged lifestyle that may help mitigate the deleterious effects of advanced age on cognitive function. As such, social activity has been examined in relation to cognitive abilities later in life. However, longitudinal evidence for this hypothesis thus far remains inconclusive. The current study sought to clarify the relationship between social activity and cognitive function over time using a coordinated data analysis approach across four longitudinal studies. A series of multilevel growth models with social activity included as a covariate is presented. Four domains of cognitive function were assessed: reasoning, memory, fluency, and semantic knowledge. Results suggest that baseline social activity is related to some, but not all, cognitive functions. Baseline social activity levels failed to predict rate of decline in most cognitive abilities. Changes in social activity were not consistently associated with cognitive functioning. Our findings do not provide consistent evidence that changes in social activity correspond to immediate benefits in cognitive functioning, except perhaps for verbal fluency.

  13. The Longitudinal Process of Early Parent Involvement on Student Achievement: A Path Analysis

    Science.gov (United States)

    Hayakawa, Momoko; Englund, Michelle M.; Warner-Richter, Mallory N.; Reynolds, Arthur J

    2016-01-01

    This longitudinal study investigated the process whereby early parent involvement in preschool effects student achievement from kindergarten through 6th grade. Participants were 1,539 low-income, mainly African American children and their mothers, in the Chicago Longitudinal Study. Program children (N = 989) received one or two years of the Child-Parent Center (CPC) program – a preschool intervention that strongly promoted parents' development of parent involvement skills within the school and at home. Children from similar backgrounds who did not attend the CPC, but participated in available local resources (e.g. day care), were obtained as a comparison group (N = 550). Path analysis revealed an interactive process between parent involvement, academic achievement, and children's motivation. Early parent involvement directly influenced kindergarten achievement, which in turn influenced first grade student motivation. Highly motivated children then encouraged parents to continue involvement. The cyclic nature of this process across elementary school was observed. The model accounted for 61% of the variance in 6th grade achievement. Findings suggest that early parent involvement promoted in the CPC program, sets the stage for subsequent parent involvement, student motivation, and academic achievement throughout early and middle childhood. PMID:27867317

  14. Meta-analysis of the changes in correlations between depression instruments used in longitudinal studies.

    Science.gov (United States)

    Bukumiric, Zoran; Starcevic, Vladan; Stanisavljevic, Dejana; Marinkovic, Jelena; Milic, Natasa; Djukic-Dejanovic, Slavica; Janjic, Vladimir; Corac, Aleksandar; Ilic, Aleksandra; Kostic, Mirjana; Nikolic, Ivan; Trajkovic, Goran

    2016-01-15

    Correlations between instruments measuring the same construct reflect their concurrent validity. Little is known about changes in correlations between such instruments employed in studies with repeated assessment. The aim of this meta-analysis was to examine the changes in correlations between depression instruments in the course of longitudinal studies. A literature search was conducted using MEDLINE and PsycINFO for the period from 1960 to 2013. The total number of collected articles was 3723, of which 61 were included. Three meta-analyses were performed for the changes in correlations between each pair of the three depression scales: Hamilton Rating Scale for Depression (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI). The effect size in these meta-analyses was obtained by the z-transformation of correlation coefficients. Correlations between depression scales increased over time in 52 studies. Significant changes in correlation coefficients were found for correlations between HAMD and BDI (pdata. A finding that correlations between depression instruments tended to increase over time has significant implications for assessment of the concurrent validity of these instruments. In longitudinal designs it is important to estimate correlations between depression scales over time because different thresholds for scale correlations indicate acceptable concurrent validity at different times. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Infectious disease research investments: systematic analysis of immunology and vaccine research funding in the UK.

    Science.gov (United States)

    Fitchett, Joseph R; Head, Michael G; Atun, Rifat

    2013-12-05

    Financing for global health is a critical element of research and development. Innovations in new vaccines are critically dependent on research funding given the large sums required, however estimates of global research investments are lacking. We evaluate infectious disease research investments, focusing on immunology and vaccine research by UK research funding organisations. In 1997-2010, £2.6 billion were spent by public and philanthropic organisations, with £590 million allocated to immunology and vaccine research. Preclinical studies received the largest funding amount £505 million accounting for 85.6% of total investment. In terms of specific infection, "the big three" infections dominated funding: HIV received £127 million (21.5% of total), malaria received £59 million (10.0% of total) and tuberculosis received £36 million (6.0% of total). We excluded industry funding from our analysis, as open-access data were unavailable. A global investment surveillance system is needed to map and monitor funding and guide allocation of scarce resources. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Interchangeability between Pneumococcal Conjugate Vaccines: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ciapponi, Agustín; Lee, Alison; Bardach, Ariel; Glujovsky, Demián; Rey-Ares, Lucila; Luisa Cafferata, María; Valanzasca, Pilar; García Martí, Sebastián

    2016-12-01

    To assess the efficacy, cost-effectiveness, immunogenicity, and safety related to the interchangeability between pneumococcal conjugate vaccines (PCVs) and vaccination schedules in pediatric population. Systematic searches were conducted in December 2010 and April 2015 for economic evaluations in MEDLINE, EMBASE, LILACS, and Cochrane Central Register of Controlled Trials. Web sites and databases from medical societies, experts, and associations related to the topic, proceedings or congressional annals, and doctoral theses were also searched. No language or temporal restriction was applied. We included randomized controlled trials, economic evaluations, and systematic reviews evaluating antibody response, cost-effectiveness, and effectiveness of PCVs' interchangeability. A Strengthening the Reporting of Observational Studies in Epidemiology-based checklist was used to assess the risk of bias in observational studies and a Cochrane approach for experimental/quasi-experimental studies. Pairs of reviewers independently selected (through the Web-based Early Reviewer Organizer Software), assessed the quality, and extracted the data of the studies. Discrepancies were resolved by consensus. We planned to perform meta-analysis whenever appropriate. Forty-six of 202 studies were included. There was no direct information available on the interchangeability between PCVs. The immunogenicity and safety between the 10-valent PCV (PCV10) and the 7-valent PCV were similar when both vaccines were coadministered with other routine pediatric vaccines. PCV10 and 13-valent PCV (PCV13) were consistently more cost-effective than 7-valent PCV. There was no direct comparative information available on the interchangeability among PCVs, but they have pretty similar immunogenicity and safety. PCV10 versus PCV13 cost-effectiveness varied according to price, indirect effects, and indirect costs. PCV10 gains more quality-adjusted life-years because of the prevention of more frequent yet less

  17. The logic of surveillance guidelines: an analysis of vaccine adverse event reports from an ontological perspective.

    Directory of Open Access Journals (Sweden)

    Mélanie Courtot

    Full Text Available BACKGROUND: When increased rates of adverse events following immunization are detected, regulatory action can be taken by public health agencies. However to be interpreted reports of adverse events must be encoded in a consistent way. Regulatory agencies rely on guidelines to help determine the diagnosis of the adverse events. Manual application of these guidelines is expensive, time consuming, and open to logical errors. Representing these guidelines in a format amenable to automated processing can make this process more efficient. METHODS AND FINDINGS: Using the Brighton anaphylaxis case definition, we show that existing clinical guidelines used as standards in pharmacovigilance can be logically encoded using a formal representation such as the Adverse Event Reporting Ontology we developed. We validated the classification of vaccine adverse event reports using the ontology against existing rule-based systems and a manually curated subset of the Vaccine Adverse Event Reporting System. However, we encountered a number of critical issues in the formulation and application of the clinical guidelines. We report these issues and the steps being taken to address them in current surveillance systems, and in the terminological standards in use. CONCLUSIONS: By standardizing and improving the reporting process, we were able to automate diagnosis confirmation. By allowing medical experts to prioritize reports such a system can accelerate the identification of adverse reactions to vaccines and the response of regulatory agencies. This approach of combining ontology and semantic technologies can be used to improve other areas of vaccine adverse event reports analysis and should inform both the design of clinical guidelines and how they are used in the future. AVAILABILITY: Sufficient material to reproduce our results is available, including documentation, ontology, code and datasets, at http://purl.obolibrary.org/obo/aero.

  18. A longitudinal analysis of prenatal exposure to methylmercury and fatty acids in the Seychelles.

    Science.gov (United States)

    Stokes-Riner, Abbie; Thurston, Sally W; Myers, Gary J; Duffy, Emeir M; Wallace, Julie; Bonham, Maxine; Robson, Paula; Shamlaye, Conrad F; Strain, J J; Watson, Gene; Davidson, Philip W

    2011-01-01

    Maternal fish consumption during pregnancy exposes the fetus simultaneously to methylmercury (MeHg) and long chain polyunsaturated fatty acids (LCPUFA). Data from the Seychelles Child Development Nutrition Study (SCDNS) showed a negative association of MeHg with child development when children were 30 months of age, only when controlling for LCPUFA. Concomitantly, n-3 LCPUFA were found to have a significant positive association only at 9 months. These findings suggest that the effects of MeHg and LCPUFA may vary with age over the first few years of life. We address this by including outcomes at two ages and adjusting for the child's age at testing. A longitudinal analysis utilizing linear mixed models was performed to assess the associations of maternal hair total mercury (THg, a biomarker for MeHg) and maternal LCPUFA with children's Bayley Scales of Infant Development Psychomotor Developmental Index (BSID-II PDI) at 9 and 30 months of age, and to determine whether these associations change over time. Data from 228 children were included. Maternal hair MeHg had a negative effect on BSID PDI, while maternal n-3 LCPUFA had a positive effect. These effects did not change significantly from 9 to 30 months in this analysis. The longitudinal analysis provides increased power for estimating the relationships of prenatal MeHg and LCPUFA exposures during child development. Significant associations of these exposures in opposite directions confirm the importance of LCPUFA in development and the need to adjust for maternal nutrition when studying prenatal MeHg exposure. Copyright © 2010 Elsevier B.V. All rights reserved.

  19. Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis.

    Directory of Open Access Journals (Sweden)

    Antonio Bernabe-Ortiz

    Full Text Available OBJECTIVE: Weight variation during therapy has been described as a useful marker to predict TB treatment outcome. No previous study has used longitudinal analysis to corroborate this finding. The goal of this study was to evaluate change and trends of patients' bodyweight over time depending on TB treatment outcome. METHODS AND FINDINGS: A retrospective cohort study with all TB cases diagnosed from 2000 to 2006 was carried out. Information from 5 public tuberculosis treatment facilities at Pampas de San Juan de Miraflores, Lima, Peru was analyzed. Poor outcome was defined as failure or death during TB therapy, and compared to good outcome defined as cured. Longitudinal analysis with a pre-specified marginal model was fitted using Generalized Estimating Equations to compare weight trends for patients with good and poor outcome adjusting for potential confounders. A total of 460 patients (55.4% males, mean age: 31.6 years were included in the analysis: 42 (9.1% had a poor outcome (17 failed and 25 died. Weight at baseline was not different comparing outcome groups (p = 0.17. After adjusting for age, gender, type of TB, scheme of treatment, HIV status and sputum variation during follow-up, after the first month of treatment, patients with good outcome gained, on average, almost 1 kg compared to their baseline weight (p<0.001, whereas those with poor outcome lost 1 kg (p = 0.003. Similarly, after 4 months, a patient with good outcome increased 3 kg on average (p<0.001, while those with poor outcome only gained 0.2 kg (p = 0.02. CONCLUSIONS: Weight variation during tuberculosis therapy follow-up can predict treatment outcome. Patients losing weight during TB treatment, especially in the first month, should be more closely followed as they are at risk of failure or death.

  20. [Prophylaxis of Community-Acquired Pneumonia Outbreaks with Pneumococcal Polysaccharide Vaccine. Prospects Analysis for Russian Military Community].

    Science.gov (United States)

    Guchev, I A; Klochkov, O I; Sinopalnikov, A I

    2016-01-01

    Pneumococcal pneumonia and other diseases caused by pneumococci still remain the main factors of high morbidity and mortality rates throughout the world. Pneumococci as the leading pathogens of community-acquired pneumonia (CAP), acute otitis media and sinusitis also cause a number of other serious systemic disorders including invasive infections with high mortality in spite of the antimicrobial resistance status and adequate antimicrobials choice. Pneumococcal infections are responsible for 5-35% or more of community-acquired pneumonias. The burden of pneumonia (up to 100-200 per thousand) is recorded among military recruits in training centers. Since the specific environment of the soldiers could be carrected, their health protection requires medical surveillance. For these reasons, polysaccharide and more immunogenic conjugated pneumococcal vaccines were developed. There is now an urgent need to understand whether such vaccines are effective in military conscripts. Controversy about the effectiveness and value of the polysaccharide (PPV-23) vaccine as a CAP morbidity restriction measure still persists. There were implemented plenty of metaanalyses of pneumococcal vaccines in adults. Some of them showed that the vaccine was effective against bacteremic pneumococcal pneumonia in 'low risk' healthy adults and elders. There have been a number of poor quality observational studies in Russia where 'all pneumonia cases' were considered as an endpoint. It remains controversial whether these observational studies provide adequate evidence to justify the use of the polysaccharide vaccine in the groups of healthy young men for whom it is being advocated. In our analysis we found weak evidence supporting pneumococcal vaccination with PPV-23 for this group. Nevertheless, favorable tendency was found to immunize. It is the reason for a trail to find pharmacoepidemiological support for vaccination by novel conjugated vaccines with better immunogenicity.

  1. Longitudinal analysis of respiratory outcomes among bauxite exposed workers in Western Australia.

    Science.gov (United States)

    Dennekamp, Martine; de Klerk, Nicholas Hubert; Reid, Alison; Abramson, Michael John; Cui, Jisheng; Del Monaco, Anthony; Fritschi, Lin; Benke, Geza Paul; Sim, Malcolm Ross; Musk, Arthur William

    2015-08-01

    Occupational exposure to bauxite is common in the aluminium industry but little is known about the associated health effects. This study investigates respiratory health in relation to respirable bauxite dust exposure longitudinally over a 13 year period. An inception cohort study recruited 91 male bauxite miners and 363 male alumina refinery workers. Annual measurements of respiratory symptoms and lung function were made. Cumulative exposure to bauxite was derived from job histories and air monitoring data. Mixed-effects modeling was used. No associations were found between cumulative bauxite exposure and respiratory symptoms or lung function. However, when analysis was restricted to the first three rounds, FEV1 was significantly lower in all exposure groups than in those unexposed but with no significant trend. Increasing exposure to bauxite dust in the aluminum industry was not associated with respiratory symptoms or consistent decrements in lung function. © 2015 Wiley Periodicals, Inc.

  2. A LONGITUDINAL ANALYSIS OF PARENTING PRACTICES, COUPLE SATISFACTION, AND CHILD BEHAVIOR PROBLEMS

    Science.gov (United States)

    Linville, Deanna; Chronister, Krista; Dishion, Tom; Todahl, Jeff; Miller, John; Shaw, Daniel; Gardner, Francis; Wilson, Melvin

    2010-01-01

    This longitudinal study examined the relationship between couple relationship satisfaction, parenting practices, parent depression, and child problem behaviors. The study participants (n = 148) were part of a larger experimental study that examined the effectiveness of a brief family-centered intervention, the Family Check-Up model. Regression analysis results indicated that our proposed model accounted for 38% of the variance in child problem behavior at Time 2, with child problem behavior and couple relationship satisfaction at child age 2 years each accounting for a significant portion of the variance in child problem behavior at age 3. Couple relationship satisfaction directly predicted child behavior problems over time. Clinical and research implications are discussed. PMID:20433599

  3. Eating patterns in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): an exploratory analysis.

    Science.gov (United States)

    Cardoso, Letícia de Oliveira; Carvalho, Marilia Sá; Cruz, Oswaldo Gonçalves; Melere, Cristiane; Luft, Vivian Cristine; Molina, Maria Del Carmen Bisi; Faria, Carolina Perim de; Benseñor, Isabela M; Matos, Sheila Maria Alvim; Fonseca, Maria de Jesus Mendes da; Griep, Rosane Harter; Chor, Dóra

    2016-01-01

    The food consumption of 15,071 public employees was analyzed in six Brazilian cities participating in the baseline for Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, 2008-2010) with the aim of identifying eating patterns and their relationship to socio-demographic variables. Multiple correspondence and cluster analysis were applied. Four patterns were identified, with their respective frequencies: "traditional" (48%); "fruits and vegetables" (25%); "pastry shop" (24%); and "diet/light" (5%) The "traditional" and "pastry shop" patterns were more frequent among men, younger individuals, and those with less schooling. "Fruits and vegetables" and "diet/light" were more frequent in women, older individuals, and those with more schooling. Our findings show the inclusion of new items in the "traditional" pattern and the appearance of the "low sugar/low fat" pattern among the eating habits of Brazilian workers, and signal socio-demographic and regional differences.

  4. Racial Disparities in Children's Health: A Longitudinal Analysis of Mothers Based on the Multiple Disadvantage Model.

    Science.gov (United States)

    Cheng, Tyrone C; Lo, Celia C

    2016-08-01

    This secondary data analysis of 4373 mothers and their children investigated racial disparities in children's health and its associations with social structural factors, social relationships/support, health/mental health, substance use, and access to health/mental health services. The study drew on longitudinal records for mother-child pairs created from data in the Fragile Families and Child Wellbeing Study. Generalized estimating equations yielded results showing children's good health to be associated positively with mother's health (current health and health during pregnancy), across three ethnic groups. For African-American children, good health was associated with mothers' education level, receipt of informal child care, receipt of public health insurance, uninsured status, and absence of depression. For Hispanic children, health was positively associated with mothers' education level, receipt of substance-use treatment, and non-receipt of public assistance. Implications for policy and intervention are discussed.

  5. Eating patterns in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil: an exploratory analysis

    Directory of Open Access Journals (Sweden)

    Letícia de Oliveira Cardoso

    2016-01-01

    Full Text Available Abstract: The food consumption of 15,071 public employees was analyzed in six Brazilian cities participating in the baseline for Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, 2008-2010 with the aim of identifying eating patterns and their relationship to socio-demographic variables. Multiple correspondence and cluster analysis were applied. Four patterns were identified, with their respective frequencies: "traditional" (48%; "fruits and vegetables" (25%; "pastry shop" (24%; and "diet/light" (5% The "traditional" and "pastry shop" patterns were more frequent among men, younger individuals, and those with less schooling. "Fruits and vegetables" and "diet/light" were more frequent in women, older individuals, and those with more schooling. Our findings show the inclusion of new items in the "traditional" pattern and the appearance of the "low sugar/low fat" pattern among the eating habits of Brazilian workers, and signal socio-demographic and regional differences.

  6. Evaluation of ventricular dysfunction using semi-automatic longitudinal strain analysis of four-chamber cine MR imaging.

    Science.gov (United States)

    Kawakubo, Masateru; Nagao, Michinobu; Kumazawa, Seiji; Yamasaki, Yuzo; Chishaki, Akiko S; Nakamura, Yasuhiko; Honda, Hiroshi; Morishita, Junji

    2016-02-01

    The aim of this study was to evaluate ventricular dysfunction using the longitudinal strain analysis in 4-chamber (4CH) cine MR imaging, and to investigate the agreement between the semi-automatic and manual measurements in the analysis. Fifty-two consecutive patients with ischemic, or non-ischemic cardiomyopathy and repaired tetralogy of Fallot who underwent cardiac MR examination incorporating cine MR imaging were retrospectively enrolled. The LV and RV longitudinal strain values were obtained by semi-automatically and manually. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff of the minimum longitudinal strain value for the detection of patients with cardiac dysfunction. The correlations between manual and semi-automatic measurements for LV and RV walls were analyzed by Pearson coefficient analysis. ROC analysis demonstrated the optimal cut-off of the minimum longitudinal strain values (εL_min) for diagnoses the LV and RV dysfunction at a high accuracy (LV εL_min = -7.8 %: area under the curve, 0.89; sensitivity, 83 %; specificity, 91 %, RV εL_min = -15.7 %: area under the curve, 0.82; sensitivity, 92 %; specificity, 68 %). Excellent correlations between manual and semi-automatic measurements for LV and RV free wall were observed (LV, r = 0.97, p cine MR imaging can evaluate LV and RV dysfunction with simply and easy measurements. The strain analysis could have extensive application in cardiac imaging for various clinical cases.

  7. Neurologic complications of vaccinations.

    Science.gov (United States)

    Miravalle, Augusto A; Schreiner, Teri

    2014-01-01

    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

  8. An analysis of the Human Papilloma Virus vaccine debate on MySpace blogs.

    Science.gov (United States)

    Keelan, Jennifer; Pavri, Vera; Balakrishnan, Ravin; Wilson, Kumanan

    2010-02-10

    The roll out of HPV immunization programs across the United States was hindered by controversy. We tracked the debate in the United States through MySpace, then the most popular social networking site, in order to better understand the public's reaction to the vaccine. We searched MySpace for all blog discourse related to HPV immunization. We analyzed each blog according to the overall portrayal of HPV immunization, identified the characteristics of the bloggers, and developed a content analysis to categorize the types of supporting arguments made. 303 blogs met our inclusion criteria. 157 (52%) of the blogs were classified as positive, 129 (43%) as negative, and 17 (6%) were ambivalent toward HPV immunization. Positive blogs generally argued that HPV infection was effective and there were no reasonable alternatives to immunizing. Negative blogs focused on the risks of immunizing and relied heavily on vaccine-critical publications to support their viewpoint. Of the blogs where gender could be identified, 75 (25%) were posted by men and 214 (71%) by women. 60% of blogs posted by men were explicitly critical about HPV immunization versus 36% of women's blogs. Male bloggers also had larger networks of friends. We describe a novel and promising approach to the surveillance of public opinions and attitudes toward immunization. In our analysis, men were far more likely to hold negative views about HPV immunization than women and disseminate negative messages through larger social networks. Blog analysis is a useful tool for Public health officials to profile vaccine criticism and to design appropriate educational information tailored to respond to alternative media/alternative information actively disseminated via social media tools. Public health officials should examine mechanisms by which to leverage this media to better communicate their message through existing networks and to engage in on-going dialogue with the public. Copyright (c) 2009 Elsevier Ltd. All rights

  9. Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis.

    Science.gov (United States)

    Smith, K J; Deschênes, S S; Schmitz, N

    2018-02-20

    Previous research has indicated an association between diabetes and anxiety. However, no synthesis has determined the direction of this association. The aim of this study was to determine the longitudinal relationship between anxiety and diabetes. We searched seven databases for studies examining the longitudinal relationship between anxiety and diabetes. Two independent reviewers screened studies from a population aged 16 or older that examined either anxiety as a risk factor for incident diabetes or diabetes as a risk factor for incident anxiety. Studies that met eligibility criteria were put forward for data extraction and meta-analysis. In total 14 studies (n = 1 760 800) that examined anxiety as a risk factor for incident diabetes and two (n = 88 109) that examined diabetes as a risk factor for incident anxiety were eligible for inclusion in the review. Only studies examining anxiety as a risk factor for incident diabetes were put forward for the meta-analysis. The least adjusted (unadjusted or adjusted for age only) estimate indicated a significant association between baseline anxiety with incident diabetes (odds ratio 1.47, 1.23-1.75). Furthermore, most-adjusted analyses indicated a significant association between baseline anxiety and incident diabetes. Included studies that examined diabetes to incident anxiety found no association. There was an association between baseline anxiety and incident diabetes. The results also indicate the need for more research to examine the direction of association from diabetes to incident anxiety. This work adds to the growing body of evidence that poor mental health increases the risk of developing diabetes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Preterm Birth: Analysis of Longitudinal Data on Siblings Based on Random-Effects Logit Models.

    Science.gov (United States)

    Bacci, Silvia; Bartolucci, Francesco; Minelli, Liliana; Chiavarini, Manuela

    2016-01-01

    The literature about the determinants of a preterm birth is still controversial. We approach the analysis of these determinants distinguishing between woman's observable characteristics, which may change over time, and unobservable woman's characteristics, which are time invariant and explain the dependence between the typology (normal or preterm) of consecutive births. We rely on a longitudinal dataset about 28,603 women who delivered for the first time in the period 2005-2013 in the Umbria Region (Italy). We consider singleton physiological pregnancies originating from natural conceptions with birthweight of at least 500 g and gestational age between 24 and 42 weeks; the overall number of deliveries is 34,224. The dataset is based on the Standard Certificates of Life Birth collected in the region in the same period. We estimate two types of logit model for the event that the birth is preterm. The first model is pooled and accounts for the information about possible previous preterm deliveries, including the lagged response among the covariates. The second model takes explicitly into account the longitudinal structure of data through the introduction of a random effect that summarizes all the (time invariant) unobservable characteristics of a woman affecting the probability of a preterm birth. The estimated models provide evidence that the probability of a preterm birth depends on certain woman's demographic and socioeconomic characteristics, other than on the previous history in terms of miscarriages and the baby's gender. Besides, as the random-effects model fits significantly better than the pooled model with lagged response, we conclude for a spurious state dependence between repeated preterm deliveries. The proposed analysis represents a useful tool to detect profiles of women with a high risk of preterm delivery. Such profiles are detected taking into account observable woman's demographic and socioeconomic characteristics as well as unobservable and

  11. An in-depth longitudinal analysis of mixing patterns in a small scientific collaboration network

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, Marko A [Los Alamos National Laboratory; Pepe, Alberto [UCLA

    2009-01-01

    Many investigations of scientific collaboration are based on large-scale statistical analyses of networks constructed from bibliographic repositories. These investigations often rely on a wealth of bibliographic data, but very little or no other information about the individuals in the network, and thus, fail to illustate the broader social and academic landscape in which collaboration takes place. In this article, we perform an in-depth longitudinal analysis of a small-scale network of scientific collaboration (N = 291) constructed from the bibliographic record of a research center involved in the development and application of sensor network technologies. We perform a preliminary analysis of selected structural properties of the network, computing its range, configuration and topology. We then support our preliminary statistical analysis with an in-depth temporal investigation of the assortativity mixing of these node characteristics: academic department, affiliation, position, and country of origin of the individuals in the network. Our qualitative analysis of mixing patterns offers clues as to the nature of the scientific community being modeled in relation to its organizational, disciplinary, institutional, and international arrangements of collaboration.

  12. Bayesian nonparametric mixed-effects joint model for longitudinal-competing risks data analysis in presence of multiple data features.

    Science.gov (United States)

    Lu, Tao

    2017-10-01

    Recently, the joint analysis of longitudinal and survival data has been an active research area. Most joint models focus on survival data with only one type of failure. The research on joint modeling of longitudinal and competing risks survival data is sparse. Even so, many joint models for this type of data assume parametric function forms for both longitudinal and survival sub-models, thus limits their use. Further, the common data features that are usually observed in practice, such as asymmetric distribution and missingness in response, measurement errors in covariate, need to be taken into account for reliable parameter estimation. The statistical inference is complicated when all these factors are considered simultaneously. In the article, driven by a motivating example, we assume nonparametric function forms for the varying coefficients in both longitudinal and competing risks survival sub-models. We propose a Bayesian nonparametric mixed-effects joint model for the analysis of longitudinal-competing risks data with asymmetry, missingness, and measurement errors. Simulation studies are conducted to assess the performance of the proposed method. We apply the proposed method to an AIDS dataset and compare a few candidate models under various settings. Some interesting results are reported.

  13. [Mumps vaccine virus transmission].

    Science.gov (United States)

    Otrashevskaia, E V; Kulak, M V; Otrashevskaia, A V; Karpov, I A; Fisenko, E G; Ignat'ev, G M

    2013-01-01

    In this work we report the mumps vaccine virus shedding based on the laboratory confirmed cases of the mumps virus (MuV) infection. The likely epidemiological sources of the transmitted mumps virus were children who were recently vaccinated with the mumps vaccine containing Leningrad-Zagreb or Leningrad-3 MuV. The etiology of the described cases of the horizontal transmission of both mumps vaccine viruses was confirmed by PCR with the sequential restriction analysis.

  14. A tool for the economic analysis of mass prophylaxis operations with an application to H1N1 influenza vaccination clinics.

    Science.gov (United States)

    Cho, Bo-Hyun; Hicks, Katherine A; Honeycutt, Amanda A; Hupert, Nathaniel; Khavjou, Olga; Messonnier, Mark; Washington, Michael L

    2011-01-01

    This article uses the 2009 H1N1 influenza vaccination program experience to introduce a cost analysis approach that may be relevant for planning mass prophylaxis operations, such as vaccination clinics at public health centers, work sites, schools, or pharmacy-based clinics. These costs are important for planning mass influenza vaccination activities and are relevant for all public health emergency preparedness scenarios requiring countermeasure dispensing. We demonstrate how costs vary depending on accounting perspective, staffing composition, and other factors. We also describe a mass vaccination clinic budgeting tool that clinic managers may use to estimate clinic costs and to examine how costs vary depending on the availability of volunteers or donated supplies and on the number of patients vaccinated per hour. Results from pilot tests with school-based H1N1 influenza vaccination clinic managers are described. The tool can also contribute to planning efforts for universal seasonal influenza vaccination.

  15. Maternal patterns of postpartum alcohol consumption by age: a longitudinal analysis of adult urban mothers.

    Science.gov (United States)

    Liu, Weiwei; Mumford, Elizabeth A; Petras, Hanno

    2015-04-01

    The purpose of this study is to investigate a) longitudinal patterns of maternal postpartum alcohol use as well as its variation by maternal age at child birth and b) within maternal age groups, the association between other maternal characteristics and alcohol use patterns for the purposes of informed prevention design. Study sample consists of 3397 mothers from the Fragile Families and Child Wellbeing Study representing medium and large US urban areas. Maternal drinking and binge drinking were measured at child age 1, 3, and 5 years. We conducted separate longitudinal latent class analysis within each of the three pre-determined maternal age groups (ages 20-25, n = 1717; ages 26-35, n = 1367; ages 36+, n = 313). Results revealed different class structures for maternal age groups. While two classes (NB [non-binge]-drinkers and LL [low-level]-drinkers) were identified for mothers in each age group, a third class (binge drinkers) was separately distinguished for the two older age groups. Whereas binge drinking rates appear to remain stable over the 5 years postdelivery for mothers who gave birth in their early twenties, mothers ages 26 and older increasingly engaged in binge drinking over time, surpassing the binge drinking behavior of younger mothers. Depression significantly increases the odds of being a NB-drinker for the 20-25 age group and that of being a binge drinker for the 36+ age group, whereas smoking during pregnancy is associated with subsequent binge drinking only for mothers ages 20-25. Findings highlight the importance of distinguishing risk factors by maternal age groups for drinking while parenting a young child, to inform the design of intervention strategies tailored to mothers of particular ages.

  16. Diagnosing the EAP needs of Turkish medical students: A longitudinal critical needs analysis

    Directory of Open Access Journals (Sweden)

    Neslihan Önder Özdemir

    2014-10-01

    Full Text Available This study uses a longitudinal critical needs analysis to diagnose the English for academic purposes (EAP needs of Turkish medical students seeking proficiency in medical English and contribute to needs analysis methodology. The data were collected from medical students and specialists. To obtain valid and reliable information about medical students’ needs, three types of instruments were used: ethnographic methods, including sustained observation and participation in a research setting; reflective journals; and a questionnaire and in-depth interview. The questionnaire design was based on essays collected from the students during their study, and the items were constructed from the students’ own words. To the best of my knowledge, this study is the first attempt in the literature to triangulate both methods and data with a focus on critical pedagogy to diagnose EAP needs. The findings are the result of the triangulation of data and methodology to ensure the reliability and validity of the findings. A total of 525 subjects participated in the research (186 participants in the pilot study and 339 participants in the main study. The findings revealed medical students’ expectations of their English for specific purposes (ESP instructor, students’ shortcomings, and the problems and strategies they use while learning medical English. The interview data analysis sought to determine whether higher education students can be a reliable source to consult for their own educational needs in higher education. The methodology followed here can be replicated in other mainstream classrooms.

  17. A genome-wide longitudinal transcriptome analysis of the aging model Podospora anserina.

    Directory of Open Access Journals (Sweden)

    Oliver Philipp

    Full Text Available Aging of biological systems is controlled by various processes which have a potential impact on gene expression. Here we report a genome-wide transcriptome analysis of the fungal aging model Podospora anserina. Total RNA of three individuals of defined age were pooled and analyzed by SuperSAGE (serial analysis of gene expression. A bioinformatics analysis identified different molecular pathways to be affected during aging. While the abundance of transcripts linked to ribosomes and to the proteasome quality control system were found to decrease during aging, those associated with autophagy increase, suggesting that autophagy may act as a compensatory quality control pathway. Transcript profiles associated with the energy metabolism including mitochondrial functions were identified to fluctuate during aging. Comparison of wild-type transcripts, which are continuously down-regulated during aging, with those down-regulated in the long-lived, copper-uptake mutant grisea, validated the relevance of age-related changes in cellular copper metabolism. Overall, we (i present a unique age-related data set of a longitudinal study of the experimental aging model P. anserina which represents a reference resource for future investigations in a variety of organisms, (ii suggest autophagy to be a key quality control pathway that becomes active once other pathways fail, and (iii present testable predictions for subsequent experimental investigations.

  18. Health economic analysis of human papillomavirus vaccines in women of Chile: perspective of the health care payer using a Markov model.

    Science.gov (United States)

    Gomez, Jorge Alberto; Lepetic, Alejandro; Demarteau, Nadia

    2014-11-26

    In Chile, significant reductions in cervical cancer incidence and mortality have been observed due to implementation of a well-organized screening program. However, it has been suggested that the inclusion of human papillomavirus (HPV) vaccination for young adolescent women may be the best prospect to further reduce the burden of cervical cancer. This cost-effectiveness study comparing two available HPV vaccines in Chile was performed to support decision making on the implementation of universal HPV vaccination. The present analysis used an existing static Markov model to assess the effect of screening and vaccination. This analysis includes the epidemiology of low-risk HPV types allowing for the comparison between the two vaccines (HPV-16/18 AS04-adjuvanted vaccine and the HPV-6/11/16/18 vaccine), latest cross-protection data on HPV vaccines, treatment costs for cervical cancer, vaccine costs and 6% discounting per the health economic guideline for Chile. Projected incremental cost-utility ratio (ICUR) and incremental cost-effectiveness ratio (ICERs) for the HPV-16/18 AS04-adjuvanted vaccine was 116 United States (US) dollars per quality-adjusted life years (QALY) gained or 147 US dollars per life-years (LY) saved, while the projected ICUR/ICER for the HPV-6/11/16/18 vaccine was 541 US dollars per QALY gained or 726 US dollars per LY saved. Introduction of any HPV vaccine to the present cervical cancer prevention program of Chile is estimated to be highly cost-effective (below 1X gross domestic product [GDP] per capita, 14278 US dollars). In Chile, the addition of HPV-16/18 AS04-adjuvanted vaccine to the existing screening program dominated the addition of HPV-6/11/16/18 vaccine. In the probabilistic sensitivity analysis results show that the HPV-16/18 AS04-adjuvanted vaccine is expected to be dominant and cost-saving in 69.3% and 77.6% of the replicates respectively. The findings indicate that the addition of any HPV vaccine to the current cervical screening

  19. An attenuated LC16m8 smallpox vaccine: analysis of full-genome sequence and induction of immune protection.

    Science.gov (United States)

    Morikawa, Shigeru; Sakiyama, Tokuki; Hasegawa, Hideki; Saijo, Masayuki; Maeda, Akihiko; Kurane, Ichiro; Maeno, Go; Kimura, Junko; Hirama, Chie; Yoshida, Teruhiko; Asahi-Ozaki, Yasuko; Sata, Tetsutaro; Kurata, Takeshi; Kojima, Asato

    2005-09-01

    The potential threat of smallpox bioterrorism has made urgent the development of lower-virulence vaccinia virus vaccines. An attenuated LC16m8 (m8) vaccine was developed in 1975 from the Lister strain used in the World Health Organization smallpox eradication program but was not used against endemic smallpox. Today, no vaccines can be tested with variola virus for efficacy in humans, and the mechanisms of immune protection against the major intracellular mature virion (IMV) and minor extracellular enveloped virion (EEV) populations of poxviruses are poorly understood. Here, we determined the full-genome sequences of the m8, parental LC16mO (mO), and grandparental Lister (LO) strains and analyzed their evolutionary relationships. Sequence data and PCR analysis indicated that m8 was a progeny of LO and that m8 preserved almost all of the open reading frames of vaccinia virus except for the disrupted EEV envelope gene B5R. In accordance with this genomic background, m8 induced 100% protection against a highly pathogenic vaccinia WR virus in mice by a single vaccination, despite the lack of anti-B5R and anti-EEV antibodies. The immunogenicity and priming efficacy with the m8 vaccine consisting mainly of IMV were as high as those with the intact-EEV parental mO and grandparental LO vaccines. Thus, mice vaccinated with 10(7) PFU of m8 produced low levels of anti-B5R antibodies after WR challenge, probably because of quick clearance of B5R-expressing WR EEV by strong immunity induced by the vaccination. These results suggest that priming with m8 IMV provides efficient protection despite undetectable levels of immunity against EEV.

  20. Will HIV vaccination reshape HIV risk behavior networks? A social network analysis of drug users' anticipated risk compensation.

    Science.gov (United States)

    Young, April M; Halgin, Daniel S; DiClemente, Ralph J; Sterk, Claire E; Havens, Jennifer R

    2014-01-01

    An HIV vaccine could substantially impact the epidemic. However, risk compensation (RC), or post-vaccination increase in risk behavior, could present a major challenge. The methodology used in previous studies of risk compensation has been almost exclusively individual-level in focus, and has not explored how increased risk behavior could affect the connectivity of risk networks. This study examined the impact of anticipated HIV vaccine-related RC on the structure of high-risk drug users' sexual and injection risk network. A sample of 433 rural drug users in the US provided data on their risk relationships (i.e., those involving recent unprotected sex and/or injection equipment sharing). Dyad-specific data were collected on likelihood of increasing/initiating risk behavior if they, their partner, or they and their partner received an HIV vaccine. Using these data and social network analysis, a "post-vaccination network" was constructed and compared to the current network on measures relevant to HIV transmission, including network size, cohesiveness (e.g., diameter, component structure, density), and centrality. Participants reported 488 risk relationships. Few reported an intention to decrease condom use or increase equipment sharing (4% and 1%, respectively). RC intent was reported in 30 existing risk relationships and vaccination was anticipated to elicit the formation of five new relationships. RC resulted in a 5% increase in risk network size (n = 142 to n = 149) and a significant increase in network density. The initiation of risk relationships resulted in the connection of otherwise disconnected network components, with the largest doubling in size from five to ten. This study demonstrates a new methodological approach to studying RC and reveals that behavior change following HIV vaccination could potentially impact risk network connectivity. These data will be valuable in parameterizing future network models that can determine if network-level change

  1. Revaccination against hepatitis B in late teenagers who received vaccination during infancy: yes or no?

    Science.gov (United States)

    Zhao, Hong; Zhou, Yi-Hua

    2017-10-30

    The significance of vaccination against hepatitis B during infancy is recognized worldwide, however, whether booster or revaccination after a period of time following the primary vaccination is required remains controversial. Recently, cross-sectional epidemiological surveys found that HBsAg prevalence in subjects born after the implementation of mass vaccination was increased with age, which was attributed to waning of anti-HBs over time. However, comprehensive analysis of the closely related cross-sectional surveys showed that the age-specific increased HBsAg prevalence was more likely associated with the carry-over of the infection occurred in early life, likely due to imperfect coverage of hepatitis B vaccination at the beginning of its introduction. Latest studies showed that booster response could be observed in the majority of individuals vaccinated 30 years ago. Moreover, confirmed breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare. Thus far no compelling evidence has been acquired to support booster vaccination in adolescence. The uncertainty regarding the duration of protection of hepatitis B vaccination, especially beyond 30 years after the primary vaccination, merits a systematically designed study to follow the same cohort of participants longitudinally, which differs from the cross-sectional studies reported previously, can hopefully offer more direct evidence to help us to determine whether revaccination of hepatitis B vaccine is necessary.

  2. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan.

    Science.gov (United States)

    Bekolo, Cavin Epie; van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Rumunu, John; Ramadan, Otim Patrick; Guha-Sapir, Debarati

    2016-09-01

    To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South Sudan on patients who developed cholera disease between 23 April and 20 July 2014 during a large outbreak, a few months after a pre-emptive oral vaccination campaign. Patients who developed severe dehydration were regarded as having a severe cholera infection. Vaccinated and unvaccinated patients were compared and multivariate logistic regression analysis was used to identify factors associated with developing severe disease or death. In total, 4115 cholera patients were treated at the 41 facilities: 1946 (47.3%) had severe disease and 62 (1.5%) deaths occurred. Multivariate analysis showed that patients who received two doses of oral cholera vaccine were 4.5-fold less likely to develop severe disease than unvaccinated patients (adjusted odds ratio, aOR: 0.22; 95% confidence interval, CI: 0.11-0.44). Moreover, those with severe cholera were significantly more likely to die than those without (aOR: 4.76; 95% CI: 2.33-9.77). Pre-emptive vaccination with two doses of oral cholera vaccine was associated with a significant reduction in the likelihood of developing severe cholera disease during an outbreak in South Sudan. Moreover, severe disease was the strongest predictor of death. Two doses of oral cholera vaccine should be used in emergencies to reduce the disease burden.

  3. The analysis of longitudinal quality of life measures with informative drop-out : A pattern mixture approach

    NARCIS (Netherlands)

    Post, W.J.; Buijs, C.; Stolk, R.P.; de Vries, E.G.E.; le Cessie, S.

    The analysis of longitudinal health-related quality of life measures (HRQOL) can be seriously hampered due to informative drop-out. Random effects models assume Missing At Random and do not take into account informative drop-out. We therefore aim to correct the bias due to informative drop-out.

  4. Recommendations to improve imaging and analysis of brain lesion load and atrophy in longitudinal studies of multiple sclerosis

    NARCIS (Netherlands)

    Vrenken, H.; Jenkinson, M.; Horsfield, M.A.; Battaglini, M.; van Schijndel, R.A.; Rostrup, E.; Geurts, J.J.G.; Fisher, E.; Zijdenbos, A.; Ashburner, J.; Miller, D. H.; Filippi, M.; Fazekas, F.; Rovaris, M.; Rovira, A.; Barkhof, F.; De Stefano, N.

    2013-01-01

    Focal lesions and brain atrophy are the most extensively studied aspects of multiple sclerosis (MS), but the image acquisition and analysis techniques used can be further improved, especially those for studying within-patient changes of lesion load and atrophy longitudinally. Improved accuracy and

  5. Longitudinal analysis of varicella-zoster virus DNA on the ocular surface associated with herpes zoster ophthalmicus

    NARCIS (Netherlands)

    Zaal, M.J.; Volker-Dieben, H.J.; Wienesen, M.; Amaro, D' J.; Kijlstra, A.

    2001-01-01

    PURPOSE: Longitudinal analysis of varicella-zoster virus DNA on the ocular surface of patients with herpes zoster ophthalmicus. METHODS: Clinical specimens were obtained from the bulbar conjunctival surface with a cotton-tipped swab at weekly intervals for 6 consecutive weeks from 21 patients with

  6. The impact of removing financial incentives from clinical quality indicators : longitudinal analysis of four Kaiser Permanente indicators

    NARCIS (Netherlands)

    Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

    2010-01-01

    OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California,

  7. Mapping and analysis of West Nile virus-specific monoclonal antibodies: prospects for vaccine development

    NARCIS (Netherlands)

    Throsby, Mark; ter Meulen, Jan; Geuijen, Cecile; Goudsmit, Jaap; de Kruif, John

    2007-01-01

    Seasonal epidemics of West Nile virus (WNV) infection now occur throughout North America, causing clinical symptoms ranging from fever to encephalitis. There are no specific treatment options or licensed vaccines. Several classically developed vaccine candidates are being evaluated in clinical

  8. Cost-benefit analysis of vaccination against paratuberculosis in dairy cattle.

    Science.gov (United States)

    van Schaik, G; Kalis, C H; Benedictus, G; Dijkhuizen, A A; Huirne, R B

    Paratuberculosis is an infectious and incurable disease which causes considerable economic losses in dairy cattle, due mainly to premature disposal and losses of milk production. In 1984 the Animal Health Service North-Netherlands started a vaccination trial in which young calves were vaccinated once, to test whether vaccination reduced the production losses and whether the overall costs of vaccination were outweighed by the benefits. Vaccination against paratuberculosis reduced the number of clinically infected animals by almost 90 per cent. It also reduced the numbers of subclinically infected animals and animals with a positive histological and/or bacteriological test result. Although vaccination did not prevent losses in milk production, it reduced the infection pressure and the clinical signs of the disease. Partial budgeting showed that vaccination against paratuberculosis was highly profitable. The costs of vaccination were US$15 per cow and the benefits (total returns minus costs) were US$142 per cow.

  9. HPV vaccine acceptability among men: a systematic review and meta-analysis

    OpenAIRE

    Newman, Peter A; Logie, Carmen H; Doukas, Nick; Asakura, Kenta

    2013-01-01

    Objective To understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability. Design Meta-analyses of cross-sectional studies. Data sources We used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV. Review methods We calculat...

  10. Promoting vaccinations - an analysis of measures taken by German statutory health insurers.

    Science.gov (United States)

    Damm, Kathrin; Schubert, Jana M; von der Schulenburg, J-Matthias

    2011-10-04

    Prophylactic vaccinations play a significant role in health care. As a relatively cost-effective preventive measure they can help to avert transmissible diseases and thus protect not only the vaccinated individuals themselves but also those who have not been vaccinated. In order to achieve this, a high vaccination rate is necessary; for many prophylactic vaccinations this rate is not reached in Germany. In order to counteract this trend the importance of prophylactic vaccinations was upgraded in 2007 within the scope of the reform of the health system. The reimbursement of patients' vaccination fees was made compulsory for the statutory health insurance companies and statutory requirements were imposed on the insurers to ensure a nationwide provision of prophylactic vaccinations for insured persons. The objective of this paper is to evaluate to what extent the health insurance companies promote the increasing of vaccination coverage rate today and what measures are being used to present this topic to the public. In order to assess the public presentation of the topic "prophylactic vaccinations" we have examined the websites of 68 statutory health insurance companies. We have assessed the attitude of the companies towards the promotion of participation in vaccination programs by conducting qualitative, structured interviews with representatives of 8 health insurers. Measures to promote vaccinations, such as information, recall offers, projects to educate people or even monetary incentives, are employed relatively extensively by the health insurers and are considered important. However, it became clear that the discussion about prophylactic vaccinations, in particular concerning the costs and benefits thereof, had not been completed yet within the companies. Vaccination-specific data is not collected or evaluated on a regular or even isolated basis. There are no concrete targets concerning specific vaccination rates and incentives are neither evaluated nor compared

  11. Controversial Ebola vaccine trials in Ghana: a thematic analysis of critiques and rebuttals in digital news.

    Science.gov (United States)

    Kummervold, Per Egil; Schulz, William S; Smout, Elizabeth; Fernandez-Luque, Luis; Larson, Heidi J

    2017-08-07

    Communication is of paramount importance in responding to health crises. We studied the media messages put forth by different stakeholders in two Ebola vaccine trials that became controversial in Ghana. These interactions between health authorities, political actors, and public citizens can offer key lessons for future research. Through an analysis of online media, we analyse stakeholder concerns and incentives, and the phases of the dispute, to understand how the dispute evolved to the point of the trials being suspended, and analyse what steps might have been taken to avert this outcome. A web-based system was developed to download and analyse news reports relevant to Ebola vaccine trials. This included monitoring major online newspapers in each country with planned clinical trials, including Ghana. All news articles were downloaded, selecting out those containing variants of the words "Ebola," and "vaccine," which were analysed thematically by a team of three coders. Two types of themes were defined: critiques of the trials and rebuttals in favour of the trials. After reconciling differences between coders' results, the data were visualised and reviewed to describe and interpret the debate. A total of 27,460 articles, published between 1 May and 30 July 2015, were collected from nine different newspapers in Ghana, of which 139 articles contained the keywords and met the inclusion criteria. The final codebook included 27 themes, comprising 16 critiques and 11 rebuttals. After coding and reconciliation, the main critiques (and their associated rebuttals) were selected for in-depth analysis, including statements about the trials being secret (mentioned in 21% of articles), claims that the vaccine trials would cause an Ebola outbreak in Ghana (33%), and the alleged impropriety of the incentives offered to participants (35%). Perceptions that the trials were "secret" arose from a combination of premature news reporting and the fact that the trials were prohibited

  12. Controversial Ebola vaccine trials in Ghana: a thematic analysis of critiques and rebuttals in digital news

    Directory of Open Access Journals (Sweden)

    Per Egil Kummervold

    2017-08-01

    Full Text Available Abstract Background Communication is of paramount importance in responding to health crises. We studied the media messages put forth by different stakeholders in two Ebola vaccine trials that became controversial in Ghana. These interactions between health authorities, political actors, and public citizens can offer key lessons for future research. Through an analysis of online media, we analyse stakeholder concerns and incentives, and the phases of the dispute, to understand how the dispute evolved to the point of the trials being suspended, and analyse what steps might have been taken to avert this outcome. Methods A web-based system was developed to download and analyse news reports relevant to Ebola vaccine trials. This included monitoring major online newspapers in each country with planned clinical trials, including Ghana. All news articles were downloaded, selecting out those containing variants of the words “Ebola,” and “vaccine,” which were analysed thematically by a team of three coders. Two types of themes were defined: critiques of the trials and rebuttals in favour of the trials. After reconciling differences between coders’ results, the data were visualised and reviewed to describe and interpret the debate. Results A total of 27,460 articles, published between 1 May and 30 July 2015, were collected from nine different newspapers in Ghana, of which 139 articles contained the keywords and met the inclusion criteria. The final codebook included 27 themes, comprising 16 critiques and 11 rebuttals. After coding and reconciliation, the main critiques (and their associated rebuttals were selected for in-depth analysis, including statements about the trials being secret (mentioned in 21% of articles, claims that the vaccine trials would cause an Ebola outbreak in Ghana (33%, and the alleged impropriety of the incentives offered to participants (35%. Discussion Perceptions that the trials were “secret” arose from a combination

  13. Longitudinal peripheral blood transcriptional analysis of a patient with severe Ebola virus disease.

    Science.gov (United States)

    Kash, John C; Walters, Kathie-Anne; Kindrachuk, Jason; Baxter, David; Scherler, Kelsey; Janosko, Krisztina B; Adams, Rick D; Herbert, Andrew S; James, Rebekah M; Stonier, Spencer W; Memoli, Matthew J; Dye, John M; Davey, Richard T; Chertow, Daniel S; Taubenberger, Jeffery K

    2017-04-12

    The 2013-2015 outbreak of Ebola virus disease in Guinea, Liberia, and Sierra Leone was unprecedented in the number of documented cases, but there have been few published reports on immune responses in clinical cases and their relationships with the course of illness and severity of Ebola virus disease. Symptoms of Ebola virus disease can include severe headache, myalgia, asthenia, fever, fatigue, diarrhea, vomiting, abdominal pain, and hemorrhage. Although experimental treatments are in development, there are no current U.S. Food and Drug Administration-approved vaccines or therapies. We report a detailed study of host gene expression as measured by microarray in daily peripheral blood samples collected from a patient with severe Ebola virus disease. This individual was provided with supportive care without experimental therapies at the National Institutes of Health Clinical Center from before onset of critical illness to recovery. Pearson analysis of daily gene expression signatures revealed marked gene expression changes in peripheral blood leukocytes that correlated with changes in serum and peripheral blood leukocytes, viral load, antibody responses, coagulopathy, multiple organ dysfunction, and then recovery. This study revealed marked shifts in immune and antiviral responses that preceded changes in medical condition, indicating that clearance of replicating Ebola virus from peripheral blood leukocytes is likely important for systemic viral clearance. Copyright © 2017, American Association for the Advancement of Science.

  14. A Longitudinal Analysis of Social Engagement in Late-Life Widowhood

    Science.gov (United States)

    Isherwood, Linda M.; King, Debra S.; Luszcz, Mary A.

    2012-01-01

    Very little is known of the longitudinal changes that occur in contact with children and participation in social activities during late-life widowhood. Using data on social networks and activities drawn from the Australian Longitudinal Study of Ageing, trajectories of change in social engagement were modeled for 1,266 participants (mean age 76.7…

  15. Training, Innovation and Business Performance: An Analysis of the Business Longitudinal Survey.

    Science.gov (United States)

    Dockery, A. Michael

    This paper uses the Australian Bureau of Statistics' Business Longitudinal Survey to explore relationships between training, innovation, and firm performance for Australian businesses with less than 200 employees. The longitudinal nature of the data is used to test various hypotheses about the nature of the link between training, business changes,…

  16. Longitudinal Analysis of Personal and Work-Related Factors Associated With Turnover Among Nurses

    NARCIS (Netherlands)

    Estryn-Behar, Madeleine; van der Heijden, Beatrice; Fry, Clementine; Hasselhorn, Hans Martin

    2010-01-01

    AB Background: Although many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. Objectives: This longitudinal study examines specific

  17. Simultaneous genetic analysis of longitudinal means and covariance structure in the simplex model using twin data

    NARCIS (Netherlands)

    Dolan, C.V.; Molenaar, P.C.M.; Boomsma, D.I.

    1991-01-01

    A longitudinal model based on the simplex model is presented to analyze simultaneously means and covariance structure using univariate longitudinal twin data. The objective of the model is to decompose the mean trend into components which can be attributed to those genetic and environmental factors

  18. In vitro characterization of pertussis vaccines : Functional analysis as part of the Consistency Approach

    NARCIS (Netherlands)

    Hoonakker, M.E.

    2017-01-01

    The current paradigm in vaccine lot release testing is that each final lot of vaccine produced is unique, due to the considerable inherent variation in the preceding biological production process. Consequently, each individual vaccine lot needs to be tested for safety and potency, frequently

  19. An extended cost-effectiveness analysis of publicly financed HPV vaccination to prevent cervical cancer in China.

    Science.gov (United States)

    Levin, Carol E; Sharma, Monisha; Olson, Zachary; Verguet, Stéphane; Shi, Ju-Fang; Wang, Shao-Ming; Qiao, You-Lin; Jamison, Dean T; Kim, Jane J

    2015-06-04

    Cervical cancer screening and existing health insurance schemes in China fall short of reaching women with prevention and treatment services, especially in rural areas where the disease burden is greatest. We conducted an extended cost-effectiveness analysis (ECEA) to evaluate public financing of HPV vaccination to prevent cervical cancer, adding new dimensions to conventional cost-effectiveness analysis through an explicit inclusion of equity and impact on financial risk protection. We synthesized available epidemiological, clinical, and economic data from China using an individual-based Monte Carlo simulation model of cervical cancer to estimate the distribution of deaths averted by income quintile, comparing vaccination plus screening against current practice. We also estimated reductions in cervical cancer incidence, net costs to the government (HPV vaccination costs minus cervical cancer treatment costs averted), and patient cost savings, as well as the incremental government health care costs per death averted. HPV vaccination is cost-effective across all income groups when the cost is less than US $50 per vaccinated girl. Compared to screening alone, adding preadolescent HPV vaccination followed by cervical cancer screening in adulthood could reduce cancer by 44 percent across all income groups, while providing relatively higher financial protection to the poorest women. The absolute numbers of cervical cancer deaths averted and the financial risk protection from HPV vaccination are highest among women in the lowest quintile; women in the bottom income quintiles received higher benefits than those in the upper wealth quintiles. Patient cost savings represent a large proportion of poor women's average per capita income, reaching 60 percent among women in the bottom income quintile and declining to 15 percent among women in the wealthiest quintile. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Hepatitis B screening and vaccination strategies for newly arrived adult Canadian immigrants and refugees: a cost-effectiveness analysis.

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    Carmine Rossi

    Full Text Available BACKGROUND: Immigrants have increased mortality from hepatocellular carcinoma as compared to the host populations, primarily due to undetected chronic hepatitis B virus (HBV infection. Despite this, there are no systematic programs in most immigrant-receiving countries to screen for chronic HBV infection and immigrants are not routinely offered HBV vaccination outside of the universal childhood vaccination program. METHODS AND FINDINGS: A cost-effective analysis was performed to compare four HBV screening and vaccination strategies with no intervention in a hypothetical cohort of newly-arriving adult Canadian immigrants. The strategies considered were a universal vaccination, b screening for prior immunity and vaccination, c chronic HBV screening and treatment, and d combined screening for chronic HBV and prior immunity, treatment and vaccination. The analysis was performed from a societal perspective, using a Markov model. Seroprevalence estimates, annual transition probabilities, health-care costs (in Canadian dollars, and utilities were obtained from the published literature. Acute HBV infection, mortality from chronic HBV, quality-adjusted life years (QALYs, and costs were modeled over the lifetime of the cohort of immigrants. Costs and QALYs were discounted at a rate of 3% per year. Screening for chronic HBV infection, and offering treatment if indicated, was found to be the most cost-effective intervention and was estimated to cost $40,880 per additional QALY gained, relative to no intervention. This strategy was most cost-effective for immigrants < 55 years of age and would cost < $50,000 per additional QALY gained for immigrants from areas where HBV seroprevalence is ≥ 3%. Strategies that included HBV vaccination were either prohibitively expensive or dominated by the chronic HBV screening strategy. CONCLUSIONS: Screening for chronic HBV infection from regions where most Canadian immigrants originate, except for Latin America and the

  1. Clinical significance of asthma clusters by longitudinal analysis in Korean asthma cohort.

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    So Young Park

    Full Text Available BACKGROUND: We have previously identified four distinct groups of asthma patients in KOREAN cohorts using cluster analysis: (A smoking asthma, (B severe obstructive asthma, (C early-onset atopic asthma, and (D late-onset mild asthma. METHODS AND RESULTS: A longitudinal analysis of each cluster in a Korean adult asthma cohort was performed to investigate the clinical significance of asthma clusters over 12 months. Cluster A showed relatively high asthma control test (ACT scores but relatively low FEV1 scores, despite a high percentage of systemic corticosteroid use. Cluster B had the lowest mean FEV1, ACT, and the quality of life questionnaire for adult Korean asthmatics (QLQAKA scores throughout the year, even though the percentage of systemic corticosteroid use was the highest among the four clusters. Cluster C was ranked second in terms of FEV1, with the second lowest percentage of systemic corticosteroid use, and showed a marked improvement in subjective symptoms over time. Cluster D consistently showed the highest FEV1, the lowest systemic corticosteroid use, and had high ACT and QLQAKA scores. CONCLUSION: Our asthma clusters had clinical significance with consistency among clusters over 12 months. These distinctive phenotypes may be useful in classifying asthma in real practice.

  2. The Walking Renaissance: A Longitudinal Analysis of Walking Travel in the Greater Los Angeles Area, USA

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    Kenneth Joh

    2015-07-01

    Full Text Available Promoting walking travel is considered important for reducing automobile use and improving public health. Recent U.S. transportation policy has incentivized investments in alternative, more sustainable transportation modes such as walking, bicycling and transit in auto-oriented cities such as Los Angeles. Although many past studies have analyzed changes in walking travel across the U.S., there is little clarity on the drivers of change. We address this gap by conducting a longitudinal analysis of walking travel in the greater Los Angeles area from 2001 to 2009. We use travel diary and household data from regional and national surveys to analyze changes in walking trip shares and rates across our study area. Results show that walking has significantly increased across most of Los Angeles, and that increases in walking trips generally correspond with increases in population, employment, and transit service densities. Estimates from fixed-effects regression analysis generally suggest a positive association between population density and walking, and that higher increases in transit stop density are correlated with increased walking trips to and from transit stops. These findings illustrate how regional planning efforts to pursue a coordinated land use-transit planning strategy can help promote walking in auto-oriented or vehicle adopting cities.

  3. Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis.

    Science.gov (United States)

    Tiura, Michael; Kim, Jinho; Detmers, Deanne; Baldi, Hilary

    2017-11-01

    Autism spectrum disorder (ASD) is a developmental disorder that causes lifelong disability. Applied Behavior Analysis (ABA) is one of the most empirically studied and validated approaches for treating children diagnosed with ASD. Due to the heterogeneity of ASD, it is important to ascertain who will most benefit from treatment. In this study, 35 participants, with a mean entry age of 3 years, received ABA therapy. Children were assessed at intake and every 6 months thereafter using the Developmental Profile-3 (DP-3) to measure their communication, social-emotional, adaptive behavior, and physical development (2-6 measures per participant). Using a growth curve analysis, we investigated if age, diagnosis severity, cognitive functioning, treatment hours, gender, parent education level, or primary language spoken at home significantly predicted the growth trajectories of ABA treatment outcomes. Our findings indicated that higher cognitive functioning significantly predicted faster growth across all four developmental domains, age at entry predicted initial status, and other variables only predicted growth rates in one or two domains. Knowing the predictors of treatment outcome is important information for customizing treatment and this study demonstrated how longitudinal analyses can illuminate how participant characteristics affect the course of ABA therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Longitudinal analysis of meta-analysis literatures in the database of ISI Web of Science.

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    Zhu, Changtai; Jiang, Ting; Cao, Hao; Sun, Wenguang; Chen, Zhong; Liu, Jinming

    2015-01-01

    The meta-analysis is regarded as an important evidence for making scientific decision. The database of ISI Web of Science collected a great number of high quality literatures including meta-analysis literatures. However, it is significant to understand the general characteristics of meta-analysis literatures to outline the perspective of meta-analysis. In this present study, we summarized and clarified some features on these literatures in the database of ISI Web of Science. We retrieved the meta-analysis literatures in the database of ISI Web of Science including SCI-E, SSCI, A&HCI, CPCI-S, CPCI-SSH, CCR-E, and IC. The annual growth rate, literature category, language, funding, index citation, agencies and countries/territories of the meta-analysis literatures were analyzed, respectively. A total of 95,719 records, which account for 0.38% (99% CI: 0.38%-0.39%) of all literatures, were found in the database. From 1997 to 2012, the annual growth rate of meta-analysis literatures was 18.18%. The literatures involved in many categories, languages, fundings, citations, publication agencies, and countries/territories. Interestingly, the index citation frequencies of the meta-analysis were significantly higher than that of other type literatures such as multi-centre study, randomize controlled trial, cohort study, case control study, and cases report (P<0.0001). The increasing numbers, intensively global influence and high citations revealed that the meta-analysis has been becoming more and more prominent in recent years. In future, in order to promote the validity of meta-analysis, the CONSORT and PRISMA standard should be continuously popularized in the field of evidence-based medicine.

  5. Efficacy of Fewer than Three Doses of an HPV-16/18 AS04 adjuvanted Vaccine: Combined Analysis of Data from the Costa Rica Vaccine Trial and the PATRICIA Trial

    Science.gov (United States)

    Kreimer, Aimée R; Struyf, Frank; Del Rosario-Raymundo, Maria Rowena; Hildesheim, Allan; Skinner, S Rachel; Wacholder, Sholom; Garland, Suzanne M; Herrero, Rolando; David, Marie-Pierre; Wheeler, Cosette M

    2015-01-01

    Background Limited data suggest one or two doses of the HPV vaccines confer similar protection to the three-dose regimen. This study aimed to further evaluate the question of reduced-dose efficacy of the HPV-16/18 vaccine. Methods Summary-level data from the Costa Rica Vaccine Trial (CVT; NCT00128661) and the PApilloma TRIal against Cancer In young Adults (PATRICIA; NCT001226810), two phase III controlled, randomized, double-blind, clinical trials of the HPV-16/18 AS04-adjuvanted vaccine among young women, were combined in a post-hoc analysis (GSK e-track 202142) to investigate efficacy of fewer doses of the HPV-16/18 vaccine after four years of follow-up. Women were randomly assigned to receive three doses of the HPV-16/18 vaccine or to a control vaccine; yet some received fewer doses. After excluding women with Costa Rica. Vaccine was provided for CVT by GlaxoSmithKline Biologicals SA, under a Clinical Trials Agreement with the NCI. GlaxoSmithKline Biologicals SA provided support for aspects of the trial associated with regulatory submission needs of the company under US Food and Drug Administration BB-IND 7920. The PATRICIA trial was sponsored by GlaxoSmithKline Biologicals SA. PMID:26071347

  6. Comparative analysis of the immune responses induced by native versus recombinant versions of the ASP-based vaccine against the bovine intestinal parasite Cooperia oncophora.

    Science.gov (United States)

    González-Hernández, Ana; Borloo, Jimmy; Peelaers, Iris; Casaert, Stijn; Leclercq, Georges; Claerebout, Edwin; Geldhof, Peter

    2018-01-01

    The protective capacities of a native double-domain activation-associated secreted protein (ndd-ASP)-based vaccine against the cattle intestinal nematode Cooperia oncophora has previously been demonstrated. However, protection analysis upon vaccination with a recombinantly produced antigen has never been performed. Therefore, the aim of the current study was to test the protective potential of a Pichia-produced double-domain ASP (pdd-ASP)-based vaccine against C. oncophora. Additionally, we aimed to compare the cellular and humoral mechanisms underlying the vaccine-induced responses by the native (ndd-ASP) and recombinant vaccines. Immunisation of cattle with the native C. oncophora vaccine conferred significant levels of protection after an experimental challenge infection, whereas the recombinant vaccine did not. Moreover, vaccination with ndd-ASP resulted in a higher proliferation of CD4-T cells both systemically and in the small intestinal mucosa when compared with animals vaccinated with the recombinant antigen. In terms of humoral response, although both native and recombinant vaccines induced similar levels of antibodies, animals vaccinated with the native vaccine were able to raise antibodies with greater specificity towards ndd-ASP in comparison with antibodies raised by vaccination with the recombinant vaccine, suggesting a differential immune recognition towards the ndd-ASP and pdd-ASP. Finally, the observation that animals displaying antibodies with higher percentages of recognition towards ndd-ASP also exhibited the lowest egg counts suggests a potential relationship between antibody specificity and protection. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  7. Strengthening capacity for AIDS vaccine research: analysis of the Pfizer Global Health Fellows program and the International AIDS Vaccine Initiative.

    Science.gov (United States)

    Vian, Taryn; Koseki, Sayaka; Feeley, Frank G; Beard, Jennifer

    2013-10-02

    Industry partnerships can help leverage resources to advance HIV/AIDS vaccine research, service delivery, and policy advocacy goals. This often involves capacity building for international and local non-governmental organizations (NGOs). International volunteering is increasingly being used as a capacity building strategy, yet little is known about how corporate volunteers help to improve performance of NGOs in the fight against HIV/AIDS. This case study helps to extend our understanding by analyzing how the Pfizer Global Health Fellows (GHF) program helped develop capacity of the International AIDS Vaccine Initiative (IAVI), looking specifically at Fellowship activities in South Africa, Kenya, and Uganda. From 2005-2009, 8 Pfizer GHF worked with IAVI and local research centers to strengthen capacity to conduct and monitor vaccine trials to meet international standards and expand trial activities. Data collection for the case study included review of Fellow job descriptions, online journals, evaluation reports, and interviews with Fellows and IAVI staff. Qualitative methods were used to analyze factors which influenced the process and outcomes of capacity strengthening. Fellows filled critical short-term expert staffing needs at IAVI as well as providing technical assistance and staff development activities. Capacity building included assistance in establishing operating procedures for the start-up period of research centers; training staff in Good Clinical Practice (GCP); developing monitoring capacity (staff and systems) to assure that centers are audit-ready at all times; and strategic planning for data management systems. Factors key to the success of volunteering partnerships included similarities in mission between the corporate and NGO partners, expertise and experience of Fellows, and attitudes of partner organization staff. By developing standard operating procedures, ensuring that monitoring and regulatory compliance systems were in place, training

  8. A LONGITUDINAL ANALYSIS REGARDING THE EVOLUTION OF PROFIT TAX REGULATIONS IN ROMANIA AN EMPIRICAL VIEW

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    Albu Nadia

    2011-07-01

    Full Text Available The study conducted a longitudinal analysis regarding Romanian profit tax regulations. Beginning with the first profit tax regulation implemented in 1991 and until now, we analyzed based on a empirical approach all changes that have occurred over time in the Romanian accounting environment. The motivation of the study conducted was based on the strong relationship between accounting and taxation in the Romanian accounting environment over time, the profit tax being one of the main items of this relation. This particular study is divided into five sections. After a short introduction and presenting the motivation of the study (section 1, in section 2 we conducted the literature review based on international and national studies regarding the profit tax regulations through the relationship between accounting and taxation. Section 3 presents a brief review of the main Romanian regulations that concerned the profit tax and the most important changes that have occurred over time. In section 4 we conducted the empirical analysis. In this section is realized a series of analysis, aiming the following: (1 the total number of regulations that have amend the main regulations presented in the previous section; (2 the type of amendments implemented over regulations (abolishment, text amendment, adding new articles or alignments; (3 the total number of amendments approved by law without modifications, respectively the total number of amendments approved on the Official Journal through Government Ordinance or Emergency Ordinance and unapproved by law. The empirical analysis conducted documented that the main shortcoming associated with the profit tax regulation is due by the multiple changes which have been subject of the 5 main profit tax regulations. The last section (section 5 consists in presenting the conclusions of the study. As main conclusion, the profit tax regulation is stable only in terms of the small number of main regulations, the large number

  9. A longitudinal study of serological responses to Coxiella burnetii and shedding at kidding among intensively-managed goats supports early use of vaccines.

    Science.gov (United States)

    Muleme, Michael; Campbell, Angus; Stenos, John; Devlin, Joanne M; Vincent, Gemma; Cameron, Alexander; Graves, Stephen; Wilks, Colin R; Firestone, Simon

    2017-09-15

    Vaccination against Coxiella burnetii, the cause of Q fever, is reportedly the only feasible strategy of eradicating infection in ruminant herds. Preventive vaccination of seronegative goats is more effective in reducing shedding of C. burnetii than vaccinating seropositive goats. The age at which goats born on heavily-contaminated farms first seroconvert to C. burnetii has not yet been documented. In a 16-month birth cohort study, the age at which goats seroconverted against C. burnetii was investigated; 95 goats were bled every 2 weeks and tested for antibodies against C. burnetii. Risk factors for seroconversion were explored and goats shedding C. burnetii were identified by testing vaginal swabs taken at the goats' first kidding using a com1 polymerase chain reaction assay. The first surge in the number of goats with IgM to C. burnetii was observed at week 9. Thus, a first vaccination not later than 8 weeks of age to control C. burnetii in highly contaminated environments is indicated. The odds of seroconversion were 2.0 times higher [95% confidence interval (CI) 1.2, 3.5] in kids born by does with serological evidence of recent infection (IgM seropositive) compared to kids born by IgM seronegative does, suggesting either in utero transmission or peri-parturient infection. The rate of seroconversion was 4.5 times higher (95% CI 2.1, 9.8) during than outside the kidding season, highlighting the risk posed by C. burnetii shed during kidding, even to goats outside the kidding herd. Shedding of C. burnetii at kidding was detected in 15 out of 41 goats infected before breeding.

  10. VICO: Ontology-based representation and integrative analysis of Vaccination Informed Consent forms.

    Science.gov (United States)

    Lin, Yu; Zheng, Jie; He, Yongqun

    2016-01-01

    Although signing a vaccination (or immunization) informed consent form is not a federal requirement in the US and Canada, such a practice is required by many states and pharmacies. The content and structures of these informed consent forms vary, which makes it hard to compare and analyze without standardization. To facilitate vaccination informed consent data standardization and integration, it is important to examine various vaccination informed consent forms, patient answers, and consent results. In this study, we report a Vaccination Informed Consent Ontology (VICO) that extends the Informed Consent Ontology and integrates related OBO foundry ontologies, such as the Vaccine Ontology, with a focus on vaccination screening questionnaire in the vaccination informed consent domain. Current VICO contains 993 terms, including 248 VICO specific terms and 709 terms imported from 17 OBO Foundry ontologies. VICO ontologically represents and integrates 12 vaccination informed consent forms from the Walgreens, Costco pharmacies, Rite AID, University of Maryland College Park, and the government of Manitoba, Canada. VICO extends Informed Consent Ontology (ICO) with vaccination screening questionnaires and questions. Our use cases and examples demonstrate five usages of VICO. First, VICO provides standard, robust and consistent representation and organization of the knowledge in different vaccination informed consent forms, questionnaires, and questions. Second, VICO integrates prior knowledge, e.g., the knowledge of vaccine contraindications imported from the Vaccine Ontology (VO). Third, VICO helps manage the complexity of the domain knowledge using logically defined ontological hierarchies and axioms. VICO glues multiple schemas that represent complex vaccination informed consent contents defined in different organizations. Fourth, VICO supports efficient query and comparison, e.g., through the Description Language (DL)-Query and SPARQL. Fifth, VICO helps discover new

  11. [Analysis of motivations for antiflu vaccination of the Clermont-Ferrand University Hospital staff].

    Science.gov (United States)

    Kelly, C; Dutheil, F; Haniez, P; Boudet, G; Rouffiac, K; Traore, O; Chamoux, A

    2008-11-01

    The vaccination of hospital staff decreases patient mortality and disorganization of services due to sick leave. The main aim of our study was to determine the Clermont-Ferrand University hospital (CHU) personnel's motivations for or against antiflu vaccination to increase the effectiveness of prevention campaigns. An autoquestionnaire with multiple choices was given to the 7601 CHU staff in May 2005. It documented socioprofessional characteristics, vaccinal status, and reasons for vaccination, nonvaccination, or stopping antiflu vaccination. The answer rate was 26.5% (2011 autoquestionnaires returned) and representative of the CHU staff. The rate of vaccination in 2004 was 36.35% with a strong correlation between vaccination and former influenza infection (p<0.001). Five of the six principal reasons for vaccination were altruistic including the first two: avoiding transmission to patients (61.8%) and his family (59.8%). The main reason for stopping was the lack of time. The reasons for nonvaccination were linked to a feeling of invulnerability: conviction of not being at risk, of being too young, or in good health. The Haute Autorité de santé's objective of vaccinal coverage against influenza for 75% of the health professionals requires their active compliance. The effectiveness of future campaigns could aim at improving knowledge by insisting particularly on the young age of the risk populations. The lack of time can be compensated by offering on-site vaccination, including at night and by proposing larger schedules for vaccination.

  12. Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies

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    Yanru Zhang

    2016-03-01

    Full Text Available Abstract Background The human papillomavirus (HPV vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population. Methods A meta-analysis was conducted across two English (PubMed, EMBASE and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines. Results Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I 2  = 98.9 % and 17.55 % (95 % CI: 12.38–24.88, I 2  = 99.8 %, respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I 2 = 98.8 % and mixed population (18.55 %; 95 % CI: 14.14–23.42, I 2 = 98.8 % exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I 2 = 98.5 %. Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I 2 = 99.0 % than the Han population (20.17 %; 95 % CI: 16.42–24.20, I 2 = 98.3 %. Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I 2 = 98.0 % and CLDA (17.78 %; 95 % CI: 12.18–24.19, I 2 = 97.6 % than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I 2 = 98.9 %. Furthermore, 67.25 % (95 % CI: 58.75–75.21, I 2  = 99.8 % of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I 2

  13. IMMUNE RESPONSE AND COST ANALYSIS OF INTRADERMAL RABIES VACCINATION FOR POST-EXPOSURE PROPHYLAXIS REGIMEN IN HUMAN

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    N. S. Budayanti

    2014-01-01

    Full Text Available BackgroundThe outbreak of rabies in human in Bali-Indonesia is causing an extraordinary pressure for the government in providing adequate doses of anti-rabies vaccine for post-exposure prophylaxis (PEP. Here, we directly compare the immune response and benefit of the intradermal (ID protocol for rabies vaccine delivery with the intramuscular (IM route. Methods: Sixty health workers who were willing to participate in this study have been randomly selected and grouped into ID, IM, and control groups, each with 20 volunteers. The Thai Red Cross ID- and Zangreb IM-protocols have been applied to the respective group. The sera of the volunteers were collected at day 0, week 1, week 3, week 4, month 3, month 6, month 9, and month 12 after the first vaccination. Anti-rabies virus IgG was detected using PlateliaTM Rabies II Kit (Bio-Rad. Results: Anti-rabies IgG could be detected in the ID-group at one week. The ID-vaccine delivery induced a slightly higher maximum antibody titer compared to IM, though not statistically significant (p>0.05. ID vaccination caused less adverse reactions and produces longer lasting protective immune response.  Cost minimization analysis (CMA on the provincial and national PEP data in 2009-2011 shows that the ID-delivery will reduce the total cost for a completed regimen by USD 28.5, and would have saved the Indonesian government budget approximately USD 3.6 and 4.3 million for complete regimens in Bali and Indonesia, respectively. Conclusion: The ID administration of anti-rabies vaccine induces a similar immune response compared to that of intramuscular injection. It also produces longer lasting protective immune response. It offers additional advantages of potential net cost savings as well as decreasing the pressure on vaccine availability due to the high number of dog bite cases.

  14. Economics of animal vaccination.

    Science.gov (United States)

    McLeod, A; Rushton, J

    2007-08-01

    This paper describes the steps that might be used in assessing the economic justification for using vaccination to control animal disease, and the way that vaccination is financed and administered. It describes decisions that have been taken with respect to preserving international trade, and issues related to protection of livelihoods. Regardless of the motivation for vaccination, its costs can usually be shared between the public and private sectors. Cost-effective vaccination requires methods of delivery to be adapted to livestock production systems. The paper concludes by suggesting questions around the use of vaccination that would merit further economic analysis.

  15. Sleep duration and memory in the elderly Chinese: longitudinal analysis of the Guangzhou Biobank Cohort Study.

    Science.gov (United States)

    Xu, Lin; Jiang, Chao Qiang; Lam, Tai Hing; Zhang, Wei Sen; Cherny, Stacey Shawn; Thomas, G Neil; Cheng, Kar Keung

    2014-11-01

    Previous cross-sectional studies showed that short or long sleep duration was associated with memory impairment (MI), but longitudinal studies are scarce. We examined whether sleep duration was associated with memory decline or development of MI. We conducted a prospective analysis based on the Guangzhou Biobank Cohort Study on 13,888 participants aged 50+ years without MI at baseline and with a follow-up for a mean of 4.1 years. Memory decline was assessed using the Delayed 10-Word Recall Test (DWRT), and in a subset (n = 6,020) with the Mini-Mental State Examination (MMSE). Short and long sleep duration was defined as ≤ 5 hours/day and ≥ 9 hours/day, respectively. Data were analyzed both continuously for memory decline and dichotomously for MI (independently defined as DWRT, multiple potential confounders, both short and long sleep durations were associated with memory decline using DWRT or MMSE score changes (all P memory decline. The observed adverse relationships provide support for an intervention study to examine the potential benefits of normalizing sleep duration in attenuating memory decline.

  16. Analysis of longitudinal multivariate outcome data from couples cohort studies: application to HPV transmission dynamics.

    Science.gov (United States)

    Kong, Xiangrong; Wang, Mei-Cheng; Gray, Ronald

    2015-06-01

    We consider a specific situation of correlated data where multiple outcomes are repeatedly measured on each member of a couple. Such multivariate longitudinal data from couples may exhibit multi-faceted correlations which can be further complicated if there are polygamous partnerships. An example is data from cohort studies on human papillomavirus (HPV) transmission dynamics in heterosexual couples. HPV is a common sexually transmitted disease with 14 known oncogenic types causing anogenital cancers. The binary outcomes on the multiple types measured in couples over time may introduce inter-type, intra-couple, and temporal correlations. Simple analysis using generalized estimating equations or random effects models lacks interpretability and cannot fully utilize the available information. We developed a hybrid modeling strategy using Markov transition models together with pairwise composite likelihood for analyzing such data. The method can be used to identify risk factors associated with HPV transmission and persistence, estimate difference in risks between male-to-female and female-to-male HPV transmission, compare type-specific transmission risks within couples, and characterize the inter-type and intra-couple associations. Applying the method to HPV couple data collected in a Ugandan male circumcision (MC) trial, we assessed the effect of MC and the role of gender on risks of HPV transmission and persistence.

  17. Longitudinal study on clinical and microbial analysis of periodontal status in pregnancy

    Directory of Open Access Journals (Sweden)

    Fernanda Campos MACHADO

    Full Text Available Abstract This study was aimed to provide a longitudinal overview of the subgingival bacterial microbiome using fluorescence in situ hybridization (FISH technique, in women in the second trimester of pregnancy (between 14 and 24 weeks, and 48 h and 8 weeks postpartum. Of 31 women evaluated during pregnancy, 24 returned for the 48-h and 18 for their 8-week exams postpartum. Probing depth (PD, bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected, and FISH was used to identify the numbers of eight periodontal pathogens. Friedman test was used to compare differences between follow-up examinations, followed by a multiple comparison test for a post hoc pairwise comparison. Clinically, a significantly greater number of teeth with PD = 4–5 mm were found during pregnancy than on postpartum examinations. Microbial analysis showed a statistically significant decrease in cell count over the study period for Prevotella nigrescens. P. intermedia, Campylobacter rectus, and Porphyromonas gingivalis also decrease, although not significantly, and Aggregatibacter actinomycetemcomitans increased. No significant changes were found for Fusobacterium nucleatum, Treponema denticola, or Tannerella forsythia. Our data demonstrate a change in the subgingival microbiota during pregnancy, at least for P. nigrescens.

  18. A Longitudinal Analysis of Changes in Job Control and Mental Health.

    Science.gov (United States)

    Bentley, Rebecca J; Kavanagh, Anne; Krnjacki, Lauren; LaMontagne, Anthony D

    2015-08-15

    Deteriorating job control has been previously shown to predict poor mental health. The impact of improvement in job control on mental health is less well understood, yet it is of policy significance. We used fixed-effects longitudinal regression models to analyze 10 annual waves of data from a large Australian panel survey (2001-2010) to test within-person associations between change in self-reported job control and corresponding change in mental health as measured by the Mental Component Summary score of Short Form 36. We found evidence of a graded relationship; with each quintile increase in job control experienced by an individual, the person's mental health increased. The biggest improvement was a 1.55-point increase in mental health (95% confidence interval: 1.25, 1.84) for people moving from the lowest (worst) quintile of job control to the highest. Separate analyses of each of the component subscales of job control-decision authority and skill discretion-showed results consistent with those of the main analysis; both were significantly associated with mental health in the same direction, with a stronger association for decision authority. We conclude that as people's level of job control increased, so did their mental health, supporting the value of targeting improvements in job control through policy and practice interventions. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Adaptive quantification and longitudinal analysis of pulmonary emphysema with a hidden Markov measure field model.

    Science.gov (United States)

    Hame, Yrjo; Angelini, Elsa D; Hoffman, Eric A; Barr, R Graham; Laine, Andrew F

    2014-07-01

    The extent of pulmonary emphysema is commonly estimated from CT scans by computing the proportional area of voxels below a predefined attenuation threshold. However, the reliability of this approach is limited by several factors that affect the CT intensity distributions in the lung. This work presents a novel method for emphysema quantification, based on parametric modeling of intensity distributions and a hidden Markov measure field model to segment emphysematous regions. The framework adapts to the characteristics of an image to ensure a robust quantification of emphysema under varying CT imaging protocols, and differences in parenchymal intensity distributions due to factors such as inspiration level. Compared to standard approaches, the presented model involves a larger number of parameters, most of which can be estimated from data, to handle the variability encountered in lung CT scans. The method was applied on a longitudinal data set with 87 subjects and a total of 365 scans acquired with varying imaging protocols. The resulting emphysema estimates had very high intra-subject correlation values. By reducing sensitivity to changes in imaging protocol, the method provides a more robust estimate than standard approaches. The generated emphysema delineations promise advantages for regional analysis of emphysema extent and progression.

  20. Recommendations to improve imaging and analysis of brain lesion load and atrophy in longitudinal studies of multiple sclerosis

    DEFF Research Database (Denmark)

    Vrenken, H; Jenkinson, M; Horsfield, M A

    2013-01-01

    Focal lesions and brain atrophy are the most extensively studied aspects of multiple sclerosis (MS), but the image acquisition and analysis techniques used can be further improved, especially those for studying within-patient changes of lesion load and atrophy longitudinally. Improved accuracy...... resonance image analysis methods for assessing brain lesion load and atrophy, this paper makes recommendations to improve these measures for longitudinal studies of MS. Briefly, they are (1) images should be acquired using 3D pulse sequences, with near-isotropic spatial resolution and multiple image...... contrasts to allow more comprehensive analyses of lesion load and atrophy, across timepoints. Image artifacts need special attention given their effects on image analysis results. (2) Automated image segmentation methods integrating the assessment of lesion load and atrophy are desirable. (3) A standard...

  1. Pharmacoeconomic aspects related to the 13-valent pneumococcal conjugate vaccine: preliminary analysis of the data from the ASL of Viterbo

    Directory of Open Access Journals (Sweden)

    Dari Silvia

    2014-12-01

    Full Text Available INTRODUCTION: Streptococcus pneumoniae is a pathogen of considerable importance to public health because it causes morbidity and mortality on the world population. It has more than 90 serotypes with different epidemiological characteristics and pathogenicity. Some categories of the population are particularly vulnerable to infection. The Regional Plan for the Prevention of Lazio for vaccination, based on the national plan for the prevention for vaccination involves the active offer of vaccination no 13-valent PCV, with a target of at least 90% in children 24 months of age.OBJECTIVE: To begin to assess the real economic impact of disease attributable to Pneumococcus, starting from the analysis of hospital discharge records (SDO of the Viterbo's ASL.METHODS: The model is structured follows the observational approach of 33 months, from January 2012 to September 2014, selecting the SDO with a principal diagnosis of Streptococcus Pneumoniae diseases and those with a principal diagnosis of respiratory diseases without etiological diagnosis, which, with good approximation, it can be considered responsible for Streptococcus pneumoniae 40%.RESULTS: From the preliminary analysis of the data, evaluating only patients diagnosed due to Pneumococcus, is known as the only pediatric cases hospitalized are between 0 and 1 year. Therefore one might assume that vaccination disbursed to the child population with 13-valent PCV, has ensured effective protection to persons of the age group 2-18 years.CONCLUSIONS: The importance of this study is the observation conducted on an ASL, (similar in size and catchment area to many Italian realty of the vaccination coverage effects, as provided by PRPV Lazio Region, on hospitalizations by Pneumococcus. The study offers a moment of reflection for decision makers, as it would be interesting to conduct pharmacoeconomic’s analysis in the presence of vaccination strategies extended to adults, especially for those at risk

  2. Optimized oral cholera vaccine distribution strategies to minimize disease incidence: A mixed integer programming model and analysis of a Bangladesh scenario.

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar; Swann, Julie; Hinman, Alan

    2015-11-17

    In addition to improved sanitation, hygiene, and better access to safe water, oral cholera vaccines can help to control the spread of cholera in the short term. However, there is currently no systematic method for determining the best allocation of oral cholera vaccines to minimize disease incidence in a population where the disease is endemic and resources are limited. We present a mathematical model for optimally allocating vaccines in a region under varying levels of demographic and incidence data availability. The model addresses the questions of where, when, and how many doses of vaccines to send. Considering vaccine efficacies (which may vary based on age and the number of years since vaccination), we analyze distribution strategies which allocate vaccines over multiple years. Results indicate that, given appropriate surveillance data, targeting age groups and regions with the highest disease incidence should be the first priority, followed by other groups primarily in order of disease incidence, as this approach is the most life-saving and cost-effective. A lack of detailed incidence data results in distribution strategies which are not cost-effective and can lead to thousands more deaths from the disease. The mathematical model allows for what-if analysis for various vaccine distribution strategies by providing the ability to easily vary parameters such as numbers and sizes of regions and age groups, risk levels, vaccine price, vaccine efficacy, production capacity and budget. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Longitudinal analysis of hemostasis biomarkers in cancer patients during antitumor treatment.

    Science.gov (United States)

    Reitter, E-M; Kaider, A; Ay, C; Quehenberger, P; Marosi, C; Zielinski, C; Pabinger, I

    2016-02-01

    ESSENTIALS: Hemostasis biomarkers impact thrombosis occurrence and survival in cancer patients. We performed a longitudinal analysis of hemostatic parameters in 112 cancer patients. Hemostatic parameters are associated with disease state, patients' prognosis, and the risk of VTE. The procoagulant state exists not only at diagnosis, but also during the course of disease. Hemostasis biomarkers are known to have an impact on venous thromboembolism (VTE) occurrence and survival in cancer patients. As there are almost no data on longitudinal changes, we aimed to evaluate those in the present prospective observational study during chemotherapy and the course of disease. Patients with cancer of the brain (n = 39), lung (n = 41), colon (n = 15) or pancreas (n = 17) were included before initiation of antitumor therapy. Blood samples for determination of factor VIII, thrombin peak height, D-dimer, F1 + 2 , fibrinogen and soluble P-selectin (sP-selectin) were drawn on a monthly basis. The study endpoints were death, VTE occurrence, or completion of the study period. Overall, 546 blood samples of 112 patients were analyzed. D-dimer and sP-selectin levels were significantly higher in patients with distant metastasis than in those without. Patients with complete remission had significantly lower levels of F1 + 2 , D-dimer and fibrinogen. Peak height thrombin levels showed a decrease over time in all tumor types. Levels of biomarkers behaved differently in the various tumor types. Patients who developed VTE (n = 14) showed increasing levels of FVIII, sP-selectin, and D-dimer. At the last blood sampling time-point before VTE occurrence, in 13 patients the D-dimer level was above the median, and in seven of these patients it was even above the 75th percentile; however, the individual course was highly variable. Regarding survival, steadily increased FVIII, sP-selectin and D-dimer levels were associated with higher mortality. Hemostatic parameters show an association with disease

  4. [Development of current smallpox vaccines].

    Science.gov (United States)

    Maksiutov, R A; Gavrilova, E V; Shchelkunov, S N

    2011-01-01

    The review gives data on the history of smallpox vaccination and shows the high topicality of designing the current safe vaccines against orthopoxviruses. Four generations of live smallpox, protein subunit, and DNA vaccines are considered. Analysis of the data published leads to the conclusion that it is promising to use the up-to-date generations of safe smallpox subunit or DNA vaccines for mass primary immunization with possible further revaccination with classical live vaccine.

  5. Overhydration prevalence in peritoneal dialysis – A 2 year longitudinal analysis1

    Directory of Open Access Journals (Sweden)

    Pedro Ventura Aguiar

    2015-03-01

    Conclusions: Peritoneal dialysis maintenance without increasing volume status, nor major deleterious corporal composition trends, is feasible under careful therapy strategies. Longitudinal application of BIA may be a useful clinical tool to evaluate adequacy beyond Kt/V.

  6. What motivates early adolescents for school? A longitudinal analysis of associations between observed teaching and motivation

    NARCIS (Netherlands)

    Stroet, Kim; Opdenakker, Marie-Christine; Minnaert, Alexander

    For many early adolescent students, motivation for school declines after their transition to secondary education. Increasingly, the decisive importance of teachers in shaping early adolescents' motivation is stressed; thus far, however, both longitudinal and observational studies on this topic have

  7. Overhydration prevalence in peritoneal dialysis – A 2 year longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Pedro Ventura Aguiar

    2015-03-01

    Conclusions: Peritoneal dialysis maintenance without increasing volume status, nor major deleterious corporal composition trends, is feasible under careful therapy strategies. Longitudinal application of BIA may be a useful clinical tool to evaluate adequacy beyond Kt/V.

  8. Employee identification before and after an internal merger: a longitudinal analysis

    NARCIS (Netherlands)

    Bartels, J.; Pruyn, A.T.H.; Jong, de M.D.T.

    2009-01-01

    Earlier studies have shown that perceived external prestige (PEP) and communication climate influence employees' overall organizational identification. This paper presents the results of a longitudinal study into the determinants of organizational identification at two organizational levels during

  9. Employee indentification before and after an internal merger: A longitudinal analysis

    NARCIS (Netherlands)

    Bartels, J.; Pruyn, Adriaan T.H.; de Jong, Menno D.T.

    2009-01-01

    Earlier studies have shown that perceived external prestige (PEP) and communication climate influence employees' overall organizational identification. This paper presents the results of a longitudinal study into the determinants of organizational identification at two organizational levels during

  10. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan

    NARCIS (Netherlands)

    Bekolo, C.E.; Loenhout, J.A. van; Rodriguez-Llanes, J.M.; Rumunu, J.; Ramadan, O.P.; Guha-Sapir, D.

    2016-01-01

    OBJECTIVE: To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. METHODS: The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South

  11. A nested case-control study of influenza vaccination was a cost-effective alternative to a full cohort analysis

    NARCIS (Netherlands)

    Hak, E; Wei, F; Grobbee, D E; Nichol, K L

    OBJECTIVE: In the absence of trial results that are applicable to the target population, nested case-control studies might be an alternative to full-cohort analysis. We compared relative and absolute estimates of associations in an influenza vaccine study using both designs. STUDY DESIGN AND

  12. The Longitudinal Process of Early Parent Involvement on Student Achievement: A Path Analysis

    OpenAIRE

    Hayakawa, Momoko; Englund, Michelle M.; Warner-Richter, Mallory N.; Reynolds, Arthur J.

    2013-01-01

    This longitudinal study investigated the process whereby early parent involvement in preschool effects student achievement from kindergarten through 6th grade. Participants were 1,539 low-income, mainly African American children and their mothers, in the Chicago Longitudinal Study. Program children (N = 989) received one or two years of the Child-Parent Center (CPC) program – a preschool intervention that strongly promoted parents' development of parent involvement skills within the school an...

  13. Hepatitis A infection in aircrews: risk of infection and cost-benefit analysis of hepatitis A vaccination.

    Science.gov (United States)

    Gutersohn, T; Steffen, R; Van Damme, P; Holdener, F; Beutels, P

    1996-02-01

    Since a hepatitis A vaccine (HAV) with long-lasting efficacy has become available, its indication in airline crews needs to be determined. Destinations in developing countries are a risk factor for hepatitis A infection in airline crews, and vaccination is cost-beneficial. Retrospective analysis was performed for all Swissair medical files for the period 1987-91. Denominator and cost data were obtained by the personnel department, and a cross-sectional seroepidemiological survey was performed in 734 Sabena staff. Among 3,322 Swissair crewmembers who spent an average of 45 nights in developing countries, 22 hepatitis A infections occurred. For the non-immune crewmembers, the overall annual incidence rate was 1.53 per 1000, whereas the incidence rate while staying in a high risk country was 12.2 per 1000. Cockpit crews with destinations limited to Europe had a rate of zero. Male flight attendants had a threefold higher rate as compared to female flight attendants or pilots. In Sabena, anti-HAV seroprevalence was 33.3%. Increased rates were observed in male as compared to female flying crews and in employees stationed abroad, whereas flying personnel had no higher rate than ground personnel. Simplified comparison of cost of infection and cost of vaccination indicates that vaccination may be cost-saving to the airline company for both male flight-attendants and pilots. Hepatitis A vaccination may be recommended to staff stationed in high risk countries and to flying crews with such destinations.

  14. Dynamic changes in cellular infiltrates with repeated cutaneous vaccination: a histologic and immunophenotypic analysis

    Directory of Open Access Journals (Sweden)

    Schaefer Jochen T

    2010-08-01

    Full Text Available Abstract Background Melanoma vaccines have not been optimized. Adjuvants are added to activate dendritic cells (DCs and to induce a favourable immunologic milieu, however, little is known about their cellular and molecular effects in human skin. We hypothesized that a vaccine in incomplete Freund's adjuvant (IFA would increase dermal Th1 and Tc1-lymphocytes and mature DCs, but that repeated vaccination may increase regulatory cells. Methods During and after 6 weekly immunizations with a multipeptide vaccine, immunization sites were biopsied at weeks 0, 1, 3, 7, or 12. In 36 participants, we enumerated DCs and lymphocyte subsets by immunohistochemistry and characterized their location within skin compartments. Results Mature DCs aggregated with lymphocytes around superficial vessels, however, immature DCs were randomly distributed. Over time, there was no change in mature DCs. Increases in T and B-cells were noted. Th2 cells outnumbered Th1 lymphocytes after 1 vaccine 6.6:1. Eosinophils and FoxP3+ cells accumulated, especially after 3 vaccinations, the former cell population most abundantly in deeper layers. Conclusions A multipeptide/IFA vaccine may induce a Th2-dominant microenvironment, which is reversed with repeat vaccination. However, repeat vaccination may increase FoxP3+T-cells and eosinophils. These data suggest multiple opportunities to optimize vaccine regimens and potential endpoints for monitoring the effects of new adjuvants. Trail Registration ClinicalTrials.gov Identifier: NCT00705640

  15. What arguments on vaccinations run through YouTube videos in Italy? A content analysis.

    Science.gov (United States)

    Covolo, Loredana; Ceretti, Elisabetta; Passeri, Chiara; Boletti, Michela; Gelatti, Umberto

    2017-07-03

    The suspension of compulsory scheduling of some pediatric vaccines has been discussed for a long time by health authorities in Italy but the current decrease of vaccination rates is a matter of concern. YouTube is the most popular video-based social media website. Considering the demonstrated impact of internet on vaccination decision-making and the increasing use of social media to share and disseminate health information, the aim of this study was to explore the message available on YouTube videos about vaccination. An observational study was conducted searching for YouTube videos in September 2015 and updated in January 2016, by using the keyword "vaccinations." We included recently posted videos in Italian on child vaccination (2014-2015). Videos were classified according to the message tone. A total of 123 videos were selected. Pro-vaccination videos were 62 (50%), anti-vaccination 28 (23%), neutral or without a clear position in favor or against vaccination 33 (27%). Focusing on the first 2 groups, pro-vaccination videos had a higher number of views compared with those unfavorable (1602 ± 6544 vs 1482 ± 2735) (p viewers (17.8 ± 31.3) than positive ones (13.2 ± 44.7) (p viewers, it is important to monitor the web to understand audience characteristics and what influences public opinions to use communication strategies more effectively.

  16. Vaccine instability in the cold chain: mechanisms, analysis and formulation strategies.

    Science.gov (United States)

    Kumru, Ozan S; Joshi, Sangeeta B; Smith, Dawn E; Middaugh, C Russell; Prusik, Ted; Volkin, David B

    2014-09-01

    Instability of vaccines often emerges as a key challenge during clinical development (lab to clinic) as well as commercial distribution (factory to patient). To yield stable, efficacious vaccine dosage forms for human use, successful formulation strategies must address a combination of interrelated topics including stabilization of antigens, selection of appropriate adjuvants, and development of stability-indicating analytical methods. This review covers key concepts in understanding the causes and mechanisms of vaccine instability including (1) the complex and delicate nature of antigen structures (e.g., viruses, proteins, carbohydrates, protein-carbohydrate conjugates, etc.), (2) use of adjuvants to further enhance immune responses, (3) development of physicochemical and biological assays to assess vaccine integrity and potency, and (4) stabilization strategies to protect vaccine antigens and adjuvants (and their interactions) during storage. Despite these challenges, vaccines can usually be sufficiently stabilized for use as medicines through a combination of formulation approaches combined with maintenance of an efficient cold chain (manufacturing, distribution, storage and administration). Several illustrative case studies are described regarding mechanisms of vaccine instability along with formulation approaches for stabilization within the vaccine cold chain. These include live, attenuated (measles, polio) and inactivated (influenza, polio) viral vaccines as well as recombinant protein (hepatitis B) vaccines. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Vaccines (immunizations) - overview

    Science.gov (United States)

    Vaccinations; Immunizations; Immunize; Vaccine shots; Prevention - vaccine ... of the vaccine. VACCINE SCHEDULE The recommended vaccination (immunization) schedule is updated every 12 months by the ...

  18. [Coverage rates of influenza vaccination in France: a population-based cross-sectional analysis of seasons 2001-2002 and 2002-2003].

    Science.gov (United States)

    Müller, D; Saliou, P; Szucs, T D

    2006-01-01

    Influenza is a serious health problem in Europe. Vaccination is the only preventive measure, reducing mortality and morbidity of influenza in all age groups. The authors had for aim to assess influenza vaccination coverage during two seasons in France, to understand the incentives and barriers to vaccination and to determine vaccination intentions for the following winter. A random-sampling, mail-based household survey was made among non-institutionalised individuals aged 15 and over. The surveys for 2001-2002 and 2002-2003 used the same questionnaire and were subsequently pooled. Three target groups were determined for analysis: (1) persons aged 65 and over; (2) people working in the medical field and (3) persons aged 65 and over or working in the medical field. Influenza vaccination coverage in France decreased from 23.0% in 2001-2002 to 22.4% in 2002-2003. Most frequent reasons for being vaccinated were advice from the family doctor (50.8%), influenza considered as a serious illness (45.3%) and free vaccine (44.1%). Reasons for not being vaccinated mentioned by people who had never been vaccinated were young age (27.0%), not considering vaccination (18.9%), and not expecting to catch influenza (13.9%). Vaccination coverage decreased during the 2002-2003 season in comparison to the 2001-2002 season. The family doctor is the most important source of encouragement for people to be vaccinated against influenza. We therefore suggest that family doctors be better informed on influenza vaccine and the disease itself, so that they can actively inform their patients on these topics.

  19. HPV vaccination and allocative efficiency: regional analysis of the costs and benefits with the bivalent AS04-adjuvanted vaccine, from the perspective of public health, for the prevention of cervical cancer and its pre-cancerous lesions

    Directory of Open Access Journals (Sweden)

    Paolo Bonanni

    2012-11-01

    Full Text Available Introduction: by means of the decisions on whether to introduce the HPV vaccination, Public Health has already established the importance of associating the vaccination strategy to the policy of secondary prevention. The screening + vaccination strategy is more effective than the two methods taken individually. In support of this combined strategy and in order to make available per each region concrete elements for their regional planning, an assessment has been made, which also takes into account the effect of cross-protection regarding high-risk strains not contained in both vaccines, bivalent and quadrivalent, and more frequently responsible for pre-cancerous lesions and cervical cancer (CCU. This analysis evaluates the costs and benefits of screening + vaccination strategy in a 12-year-old female cohort. Furthermore, the paper provides results that may be useful to assess the opportunity to extend the vaccination to a second cohort of 24-25-year-old women. The analysis is preceded by a brief summary of CCU epidemiology available data, public health policies that give precise guidelines for vaccination strategies and analytical tools suitable to support public policy makers to efficiently allocate resources. Methods: two different models were used for two regional analyses.The vaccines may have different sustained- and cross-protection levels against non-vaccine oncogenic HPV-types. In the first analysis, a prevalence-based model estimated the potential net difference in HPV-related lesions (abnormal pap smear, cervical intraepithelial neoplasia (CIN, cervical cancer (CC and genital warts (GW and associated costs generated by the two vaccines. Vaccine efficacy rates were based on published data for each vaccine. Lifetime vaccine efficacy was assumed. Results are reported over one year after reaching a steady state. Incidence and treatment costs were obtained from Italian and European sources. We also performed a cost-effectiveness analysis

  20. Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis.

    Science.gov (United States)

    Drolet, Mélanie; Bénard, Élodie; Boily, Marie-Claude; Ali, Hammad; Baandrup, Louise; Bauer, Heidi; Beddows, Simon; Brisson, Jacques; Brotherton, Julia M L; Cummings, Teresa; Donovan, Basil; Fairley, Christopher K; Flagg, Elaine W; Johnson, Anne M; Kahn, Jessica A; Kavanagh, Kimberley; Kjaer, Susanne K; Kliewer, Erich V; Lemieux-Mellouki, Philippe; Markowitz, Lauri; Mboup, Aminata; Mesher, David; Niccolai, Linda; Oliphant, Jeannie; Pollock, Kevin G; Soldan, Kate; Sonnenberg, Pam; Tabrizi, Sepehr N; Tanton, Clare; Brisson, Marc

    2015-05-01

    Human papillomavirus (HPV) vaccination programmes were first implemented in several countries worldwide in 2007. We did a systematic review and meta-analysis to assess the population-level consequences and herd effects after female HPV vaccination programmes, to verify whether or not the high efficacy reported in randomised controlled clinical trials are materialising in real-world situations. We searched the Medline and Embase databases (between Jan 1, 2007 and Feb 28, 2014) and conference abstracts for time-trend studies that analysed changes, between the pre-vaccination and post-vaccination periods, in the incidence or prevalence of at least one HPV-related endpoint: HPV infection, anogenital warts, and high-grade cervical lesions. We used random-effects models to derive pooled relative risk (RR) estimates. We stratified all analyses by age and sex. We did subgroup analyses by comparing studies according to vaccine type, vaccination coverage, and years since implementation of the vaccination programme. We assessed heterogeneity across studies using I(2) and χ(2) statistics and we did trends analysis to examine the dose-response association between HPV vaccination coverage and each study effect measure. We identified 20 eligible studies, which were all undertaken in nine high-income countries and represent more than 140 million person-years of follow-up. In countries with female vaccination coverage of at least 50%, HPV type 16 and 18 infections decreased significantly between the pre-vaccination and post-vaccination periods by 68% (RR 0·32, 95% CI 0·19-0·52) and anogenital warts decreased significantly by 61% (0·39, 0·22-0·71) in girls 13-19 years of age. Significant reductions were also recorded in HPV types 31, 33, and 45 in this age group of girls (RR 0·72, 95% CI 0·54-0·96), which suggests cross-protection. Additionally, significant reductions in anogenital warts were also reported in boys younger than 20 years of age (0·66 [95% CI 0·47-0·91

  1. Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis

    Science.gov (United States)

    Drolet, Mélanie; Bénard, Élodie; Boily, Marie-Claude; Ali, Hammad; Baandrup, Louise; Bauer, Heidi; Beddows, Simon; Brisson, Jacques; Brotherton, Julia M L; Cummings, Teresa; Donovan, Basil; Fairley, Christopher K; Flagg, Elaine W; Johnson, Anne M; Kahn, Jessica A; Kavanagh, Kimberley; Kjaer, Susanne K; Kliewer, Erich V; Lemieux-Mellouki, Philippe; Markowitz, Lauri; Mboup, Aminata; Mesher, David; Niccolai, Linda; Oliphant, Jeannie; Pollock, Kevin G; Soldan, Kate; Sonnenberg, Pam; Tabrizi, Sepehr N; Tanton, Clare; Brisson, Marc

    2016-01-01

    Summary Background Human papillomavirus (HPV) vaccination programmes were first implemented in several countries worldwide in 2007. We did a systematic review and meta-analysis to assess the population-level consequences and herd effects after female HPV vaccination programmes, to verify whether or not the high efficacy reported in randomised controlled clinical trials are materialising in real-world situations. Methods We searched the Medline and Embase databases (between Jan 1, 2007 and Feb 28, 2014) and conference abstracts for time-trend studies that analysed changes, between the pre-vaccination and post-vaccination periods, in the incidence or prevalence of at least one HPV-related endpoint: HPV infection, anogenital warts, and high-grade cervical lesions. We used random-effects models to derive pooled relative risk (RR) estimates. We stratified all analyses by age and sex. We did subgroup analyses by comparing studies according to vaccine type, vaccination coverage, and years since implementation of the vaccination programme. We assessed heterogeneity across studies using I2 and χ2 statistics and we did trends analysis to examine the dose–response association between HPV vaccination coverage and each study effect measure. Findings We identified 20 eligible studies, which were all undertaken in nine high-income countries and represent more than 140 million person-years of follow-up. In countries with female vaccination coverage of at least 50%, HPV type 16 and 18 infections decreased significantly between the pre-vaccination and post-vaccination periods by 68% (RR 0·32, 95% CI 0·19–0·52) and anogenital warts decreased significantly by 61% (0·39, 0·22–0·71) in girls 13–19 years of age. Significant reductions were also recorded in HPV types 31, 33, and 45 in this age group of girls (RR 0·72, 95% CI 0·54–0·96), which suggests cross-protection. Additionally, significant reductions in anogenital warts were also reported in boys younger than 20

  2. Changes in prevalence of ovine paratuberculosis following vaccination with Gudair®: Results of a longitudinal study conducted over a decade.

    Science.gov (United States)

    Dhand, Navneet K; Eppleston, Jeff; Whittington, Richard J; Windsor, Peter A

    2016-09-30

    Since its registration in 2002, Gudair® vaccine has become the key tool for managing paratuberculosis in sheep in Australia. This study was conducted to evaluate its effectiveness in reducing paratuberculosis prevalence in 12 flocks over more than one decade. Flocks with variable initial prevalence (5, 4 and 3 with low, medium, and high prevalence, respectively) were enrolled in the study in 2003-04. Six biennial faecal samplings were conducted in these flocks over a 10year period. At each sampling, faeces from four age groups (3, 4, 5 and 6year-old sheep) were collected from each flock. The aim was to select 7 or 14 pools of faeces constituted with pellets from 50 or 25 sheep from each age group, respectively, but the numbers and sizes of pools did vary due to logistical issues. Samples were cultured using pooled faecal culture approach and sheep level paratuberculosis prevalence was estimated. Changes in probability of a pool being positive and in paratuberculosis prevalence over time were evaluated by fitting generalised-linear and linear mixed models. The proportion of positive faecal pools significantly declined over time from 50.3% at the first sampling in 2003-04 to only 3.1% at the last sampling in 2013-14, suggestive of a 30-fold reduction in the odds of a pooled faecal sample to be positive (pparatuberculosis vaccine effectiveness. The results will enable sheep producers to make informed decisions on managing paratuberculosis, and in evaluating the risks of purchasing and trading vaccinated sheep. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies.

    Science.gov (United States)

    Kuiper, Jisca S; Zuidersma, Marij; Zuidema, Sytse U; Burgerhof, Johannes Gm; Stolk, Ronald P; Oude Voshaar, Richard C; Smidt, Nynke

    2016-08-01

    Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline. MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these. We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies. Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  4. Association between earthquake events and cholera outbreaks: a cross-country 15-year longitudinal analysis.

    Science.gov (United States)

    Sumner, Steven A; Turner, Elizabeth L; Thielman, Nathan M

    2013-12-01

    Large earthquakes can cause population displacement, critical sanitation infrastructure damage, and increased threats to water resources, potentially predisposing populations to waterborne disease epidemics such as cholera. Problem The risk of cholera outbreaks after earthquake disasters remains uncertain. A cross-country analysis of World Health Organization (WHO) cholera data that would contribute to this discussion has yet to be published. A cross-country longitudinal analysis was conducted among 63 low- and middle-income countries from 1995-2009. The association between earthquake disasters of various effect sizes and a relative spike in cholera rates for a given country was assessed utilizing fixed-effects logistic regression and adjusting for gross domestic product per capita, water and sanitation level, flooding events, percent urbanization, and under-five child mortality. Also, the association between large earthquakes and cholera rate increases of various degrees was assessed. Forty-eight of the 63 countries had at least one year with reported cholera infections during the 15-year study period. Thirty-six of these 48 countries had at least one earthquake disaster. In adjusted analyses, country-years with ≥10,000 persons affected by an earthquake had 2.26 times increased odds (95 CI, 0.89-5.72, P = .08) of having a greater than average cholera rate that year compared to country-years having earthquake. The association between large earthquake disasters and cholera infections appeared to weaken as higher levels of cholera rate increases were tested. A trend of increased risk of greater than average cholera rates when more people were affected by an earthquake in a country-year was noted. However these findings did not reach statistical significance at traditional levels and may be due to chance. Frequent large-scale cholera outbreaks after earthquake disasters appeared to be relatively uncommon.

  5. Sexual quality of life in Hodgkin Lymphoma: a longitudinal analysis by the German Hodgkin Study Group.

    Science.gov (United States)

    Behringer, K; Müller, H; Görgen, H; Flechtner, H-H; Brillant, C; Halbsguth, T V; Thielen, I; Eichenauer, D A; Schober, T; Nisters-Backes, H; Fuchs, M; Engert, A; Borchmann, P

    2013-01-15

    Health-related quality of life (HRQoL) comprises different domains of physical, mental, and social well-being. In this analysis, we focus on sexual quality of life in Hodgkin Lymphoma (HL) patients. Four-thousand one-hundred and sixty patients enroled in the HD10-HD12 trials underwent HRQoL assessment. Instruments included the Quality of Life Questionnaire for survivors (QLQ-S), combining the European Organisation for Research and Treatment of Cancer QLQ-C30, Multidimensional fatigue (FA) inventory (MFI-20) and an additional sexual functioning (SX) scale. We describe SX up to 27 months after therapy and analyse relationship to stage, age, gender, FA, social functioning, and therapy. Statistical methods range from descriptive statistics to a classification of SX courses, and a longitudinal structural equations model with full information maximum likelihood estimation of missing data. In the analysis, a score below 50 was used to describe severe sexual dysfunction. Three-thousand two-hundred and eight patients provided data on SX. Patients in advanced stages reported lower SX than patients in early stages both, before and after the treatment. During follow-up, an improvement of SX compared with baseline was detected, except for those ≥50 years. Patients in early stages reached normal SX, whereas advanced-stage patients remained below the reference value for healthy controls. Sexual functioning during follow-up was significantly and strongly related to previous SX, other HRQoL measures, age, and stage, and to lesser degree with gender and chemotherapy. Overall, HL patients have a decreased sexual quality of life at baseline, which improves after therapy and normalises in early-stage patients. Importantly, long-term SX is more closely related to patient characteristics and SX at baseline than to the intensity of treatment.

  6. Analysis of peripheral blood immune cells after prophylactic immunization with HPV-16/18 ASO4-adjuvanted vaccine

    Directory of Open Access Journals (Sweden)

    Iwona Hus

    2015-04-01

    Full Text Available Persistent infection with oncogenic types of human papillomavirus (HPV is a causal factor for more than 99% of cervical cancers. Recently, prophylactic vaccines have been developed to prevent infections with cancer-associated HPV types (HPV16 and HPV18. The aim of this study was to analyze the changes in the immune system that occur within four weeks of the first dose of HPV-16/18 ASO4-adjuvanted vaccine. Assessment of the percentages of selected cell populations in peripheral blood of 20 healthy volunteers vaccinated with Cervarix was performed using flow cytometry. The analysis revealed an increase in the proportion of activated B and CD4+ T helper cells and an absence of significant differences in cytotoxic CD8+ T lymphocytes, indicating activation of the humoral response after vaccination, without a significant effect on cellular response. There were no significant changes in the NK cell population, and there was a reduction of the percentage of NKT-like cells, which may result from expiry of the primary response at the time of analysis. The presented results are preliminary, and in the context of the increasing use of the anti-HPV vaccine, it would be worth continuing the study in larger groups of patients and at earlier and later time points in combination with the measurement of specific anti-HPV16 and -HPV18 antibody levels. Such an assessment could therefore contribute not only to better understanding of the exact mechanism of action of the vaccine, but also to defining the immunological parameters that determine its effectiveness.

  7. Analysis of peripheral blood immune cells after prophylactic immunization with HPV-16/18 ASO4-adjuvanted vaccine.

    Science.gov (United States)

    Hus, Iwona; Gonet-Sebastianka, Joanna; Surdacka, Agata; Bojarska-Junak, Agnieszka; Roliński, Jacek

    2015-04-28

    Persistent infection with oncogenic types of human papillomavirus (HPV) is a causal factor for more than 99% of cervical cancers. Recently, prophylactic vaccines have been developed to prevent infections with cancer-associated HPV types (HPV16 and HPV18). The aim of this study was to analyze the changes in the immune system that occur within four weeks of the first dose of HPV-16/18 ASO4-adjuvanted vaccine. Assessment of the percentages of selected cell populations in peripheral blood of 20 healthy volunteers vaccinated with Cervarix was performed using flow cytometry. The analysis revealed an increase in the proportion of activated B and CD4+ T helper cells and an absence of significant differences in cytotoxic CD8+ T lymphocytes, indicating activation of the humoral response after vaccination, without a significant effect on cellular response. There were no significant changes in the NK cell population, and there was a reduction of the percentage of NKT-like cells, which may result from expiry of the primary response at the time of analysis. The presented results are preliminary, and in the context of the increasing use of the anti-HPV vaccine, it would be worth continuing the study in larger groups of patients and at earlier and later time points in combination with the measurement of specific anti-HPV16 and -HPV18 antibody levels. Such an assessment could therefore contribute not only to better understanding of the exact mechanism of action of the vaccine, but also to defining the immunological parameters that determine its effectiveness.

  8. Intrathecal antibody production in two cases of yellow fever vaccine associated neurotropic disease in Argentina.

    Science.gov (United States)

    Pires-Marczeski, Fanny Clara; Martinez, Valeria Paula; Nemirovsky, Corina; Padula, Paula Julieta

    2011-12-01

    During the period 2007-2008 several epizootics of Yellow fever with dead of monkeys occurred in southeastern Brasil, Paraguay, and northeastern Argentina. In 2008 after a Yellow fever outbreak an exhaustive prevention campaign took place in Argentina using 17D live attenuated Yellow fever vaccine. This vaccine is considered one of the safest live virus vaccines, although serious adverse reactions may occur after vaccination, and vaccine-associated neurotropic disease are reported rarely. The aim of this study was to confirm two serious adverse events associated to Yellow fever vaccine in Argentina, and to describe the analysis performed to assess the origin of specific IgM against Yellow fever virus (YFV) in cerebrospinal fluid (CSF). Both cases coincided with the Yellow fever vaccine-associated neurotropic disease case definition, being clinical diagnosis longitudinal myelitis (case 1) and meningoencephalitis (case 2). Specific YFV antibodies were detected in CSF and serum samples in both cases by IgM antibody-capture ELISA. No other cause of neurological disease was identified. In order to obtain a conclusive diagnosis of central nervous system (CNS) infection the IgM antibody index (AI(IgM) ) was calculated. High AI(IgM) values were found in both cases indicating intrathecal production of antibodies and, therefore, CNS post-vaccinal YFV infection could be definitively associated to YFV vaccination. Copyright © 2011 Wiley Periodicals, Inc.

  9. Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies.

    Science.gov (United States)

    Taylor, Luke E; Swerdfeger, Amy L; Eslick, Guy D

    2014-06-17

    There has been enormous debate regarding the possibility of a link between childhood vaccinations and the subsequent development of autism. This has in recent times become a major public health issue with vaccine preventable diseases increasing in the community due to the fear of a 'link' between vaccinations and autism. We performed a meta-analysis to summarise available evidence from case-control and cohort studies on this topic (MEDLINE, PubMed, EMBASE, Google Scholar up to April, 2014). Eligible studies assessed the relationship between vaccine administration and the subsequent development of autism or autism spectrum disorders (ASD). Two reviewers extracted data on study characteristics, methods, and outcomes. Disagreement was resolved by consensus with another author. Five cohort studies involving 1,256,407 children, and five case-control studies involving 9,920 children were included in this analysis. The cohort data revealed no relationship between vaccination and autism (OR: 0.99; 95% CI: 0.92 to 1.06) or ASD (OR: 0.91; 95% CI: 0.68 to 1.20), nor was there a relationship between autism and MMR (OR: 0.84; 95% CI: 0.70 to 1.01), or thimerosal (OR: 1.00; 95% CI: 0.77 to 1.31), or mercury (Hg) (OR: 1.00; 95% CI: 0.93 to 1.07). Similarly the case-control data found no evidence for increased risk of developing autism or ASD following MMR, Hg, or thimerosal exposure when grouped by condition (OR: 0.90, 95% CI: 0.83 to 0.98; p=0.02) or grouped by exposure type (OR: 0.85, 95% CI: 0.76 to 0.95; p=0.01). Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Vaccine hesitancy

    Science.gov (United States)

    Dubé, Eve; Laberge, Caroline; Guay, Maryse; Bramadat, Paul; Roy, Réal; Bettinger, Julie A.

    2013-01-01

    Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccine-preventable disease outbreaks and epidemics. This review provides an overview of the phenomenon of vaccine hesitancy. First, we will characterize vaccine hesitancy and suggest the possible causes of the apparent increase in vaccine hesitancy in the developed world. Then we will look at determinants of individual decision-making about vaccination. PMID:23584253

  11. Multicriteria decision analysis and core values for enhancing vaccine-related decision-making.

    Science.gov (United States)

    Barocchi, Michèle A; Black, Steve; Rappuoli, Rino

    2016-06-29

    Vaccines have the potential to transform the health of all individuals and to reduce the health inequality between rich and poor countries. However, to achieve these goals, it is no longer sufficient to prioritize vaccine development using cost-effectiveness as the sole indicator. During a symposium entitled "Mission Grand Convergence-The Role of Vaccines," held in Siena, Italy, in July 2015, key stakeholders agreed that the prioritization of vaccine development and deployment must use multicriteria decision-making based on the following core concepts: (i) mortality and severity of the disease, (ii) vaccine safety considerations, and (iii) economic evaluation that captures the full benefits of vaccination. Copyright © 2016, American Association for the Advancement of Science.

  12. Fault detection in bars axially loaded by the analysis of its longitudinal displacement; Deteccao de falhas em barras solicitadas axialmente pela analise do seu deslocamento longitudinal

    Energy Technology Data Exchange (ETDEWEB)

    Nascimento, J.L.; Irmao, M.A.S.; Araujo, A.L.; Silva, A.A. [Universidade Federal de Campina Grande (UFCG), PB (Brazil). Dept. de Engenharia Mecanica

    2004-07-01

    Structures and mechanical components, subjects to conditions of loading in operation, accumulate faults during your useful lives. The detection and condition monitoring of the faults is essential of the point of view of the efficiency and safety. Efforts have been accomplished, in the sense of constituting models and methodologies that indicate the most opportune moment for the shut down industrial plant, seeking your maintenance. In the present work, it intends an alternative method for the detection and the condition monitoring of faults in a cantilever bar by the analysis of your longitudinal displacement. The methodology is constituted basically in simulating the computational model of the bar for Finite Element Method (FEM), where the faults are characterized by one of the elements with reduced transverse section. The existence of two classes of angular coefficients is noticed, that will be the analysis parameters, where the first tells respect the intact element and the second the damaged element, both different ones for each position and depth of simulated faults. The same ones are thrown as input in a Artificial Neural Networks, that once trained is capable to identify the position and the depth efficiently in that meets the faults. (author)

  13. Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence

    Directory of Open Access Journals (Sweden)

    Lang PO

    2012-02-01

    Full Text Available Pierre-Olivier Lang1,2, Aline Mendes1, Jennifer Socquet1, Noémie Assir1, Sheila Govind2, Richard Aspinall21Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and Medical School of Geneva, Geneva, Switzerland; 2Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield, EnglandAbstract: Foremost amongst the diseases preventable by vaccination is influenza. Worldwide, influenza virus infection is associated with serious adverse events leading to hospitalization, debilitating complications, and death in elderly individuals. Immunization is considered to be the cornerstone for preventing these adverse health outcomes, and vaccination programs are timed to optimize protection during the annual influenza season. Trivalent inactivated influenza virus vaccines are believed to be both effective and cost-saving; however, in spite of widespread influenza vaccination programs, rates of hospitalization for acute respiratory illness and cardiovascular diseases have been increasing in this population during recent annual influenza seasons. From meta-analyses summarizing estimates of influenza vaccine effectiveness from available observational clinical studies, this review aims to examine how effective current influenza vaccine strategies are in the aging and older adult population and to analyze which are the most important biases that interfere with measurements of influenza vaccine effectiveness. Furthermore, consideration is given to strategies that should be adopted in order to optimize influenza vaccine effectiveness in the face of immune exhaustion.Keywords: influenza vaccine effectiveness, influenza virus infection, immunosenescence, hemagglutinin activity inhibition, innate immunity, hemagglutinin inhibition, older adults

  14. A New Method for the Evaluation of Vaccine Safety Based on Comprehensive Gene Expression Analysis

    Directory of Open Access Journals (Sweden)

    Haruka Momose

    2010-01-01

    Full Text Available For the past 50 years, quality control and safety tests have been used to evaluate vaccine safety. However, conventional animal safety tests need to be improved in several aspects. For example, the number of test animals used needs to be reduced and the test period shortened. It is, therefore, necessary to develop a new vaccine evaluation system. In this review, we show that gene expression patterns are well correlated to biological responses in vaccinated rats. Our findings and methods using experimental biology and genome science provide an important means of assessment for vaccine toxicity.

  15. A longitudinal analysis of cross-border ties and depression for Latino adults.

    Science.gov (United States)

    Torres, Jacqueline M; Lee, Anne; González, Hector M; Garcia, Lorena; Haan, Mary N

    2016-07-01

    Recent scholarship suggests a significant association between cross-border ties, or ties maintained with family and friends in countries and communities of origin, and the mental health of immigrants and their descendants. To date, this research has been exclusively cross-sectional, precluding conclusions about a causal association between cross-border ties and mental health outcomes. In the present study we undertake a longitudinal analysis of the relationship between cross-border ties and depression measured over a ten-year period for a sample of immigrant and U.S.-born Latinos. Data are from the Sacramento Area Latino Study on Aging (1998-2008), a population-based, prospective study of Latin American-origin adults 60 years and older. We find that cross-border ties reported at baseline were significantly associated with depression in subsequent study waves, even after controlling for the presence of depression at baseline, albeit with substantial differences by gender and nativity. Specifically, communication with family and friends in Latin America and travel to Latin America at baseline were each significantly associated with greater odds of depression for immigrant women, but with lower odds of depression for U.S.-born Latina women over the study period. Travel to Latin America at baseline was significantly associated with lower odds of depression for Latino men across the study. Across all models we control for depressive symptomatology at baseline to account for the reciprocal nature of depressive symptoms and engagement with social ties, including cross-border ties. Our findings suggest that cross-border ties may represent a unique source of both resilience and risk for the long-term mental health of immigrant Latinos and their descendants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Monthly food insecurity assessment in rural mkushi district, Zambia: a longitudinal analysis

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    Muzi Na

    2017-03-01

    Full Text Available Abstract Background Perception-based scales are widely used for household food insecurity (HFI assessment but were only recently added in national surveys. The frequency of assessments needed to characterize dynamics in HFI over time is largely unknown. The study aims to examine longitudinal changes in monthly reported HFI at both population- and household-level. Methods A total of 157 households in rural Mkushi District whose children were enrolled in the non-intervened arm of an efficacy trial of biofortified maize were included in the analysis. HFI was assessed by a validated 8-item perception-based Likert scale on a monthly basis from October 2012 to March 2013 (6 visits, characterizing mostly the lean season. An HFI index was created by summing scores over the Likert scale, with a possible range of 0–32. The Wilcoxon matched signed-ranks test was used to compare distribution of HFI index between visits. A random effect model was fit to quantify the sources of variance in indices at household level. Results The median [IQR] HFI index was 4.5 [2, 8], 5 [1, 8], 4 [1, 7], 4 [1, 6], 3 [1, 7] and 4 [1, 6] at the six monthly visits, respectively. HFI index was significantly higher in visit 1 and 2 than visit 3–6 and on average the index decreased by 0.25 points per visit. Within- and between-household variance in the index were 10.6 and 8.8, respectively. Conclusions The small change in mean monthly HFI index over a single lean season indicated that a seasonal HFI measure may be sufficient for monitoring purposes at population level. Yet, higher variation within households suggests that repeated assessments may be required to avoid risk of misclassification at household level and to target households with the greatest risk of food insecurity.

  17. Longitudinal Analysis of Music Education on Executive Functions in Primary School Children

    Directory of Open Access Journals (Sweden)

    Artur C. Jaschke

    2018-02-01

    Full Text Available Background: Research on the effects of music education on cognitive abilities has generated increasing interest across the scientific community. Nonetheless, longitudinal studies investigating the effects of structured music education on cognitive sub-functions are still rare. Prime candidates for investigating a relationship between academic achievement and music education appear to be executive functions such as planning, working memory, and inhibition.Methods: One hundred and forty-seven primary school children, Mage = 6.4 years, SD = 0.65 were followed for 2.5 years. Participants were randomized into four groups: two music intervention groups, one active visual arts group, and a no arts control group. Neuropsychological tests assessed verbal intelligence and executive functions. Additionally, a national pupil monitor provided data on academic performance.Results: Children in the visual arts group perform better on visuospatial memory tasks as compared to the three other conditions. However, the test scores on inhibition, planning and verbal intelligence increased significantly in the two music groups over time as compared to the visual art and no arts controls. Mediation analysis with executive functions and verbal IQ as mediator for academic performance have shown a possible far transfer effect from executive sub-function to academic performance scores.Discussion: The present results indicate a positive influence of long-term music education on cognitive abilities such as inhibition and planning. Of note, following a two-and-a-half year long visual arts program significantly improves scores on a visuospatial memory task. All results combined, this study supports a far transfer effect from music education to academic achievement mediated by executive sub-functions.

  18. Factors affecting the achievement of fertility intentions in urban Nigeria: analysis of longitudinal data.

    Science.gov (United States)

    Babalola, Stella; Oyenubi, Olamide; Speizer, Ilene S; Cobb, Lisa; Akiode, Akinsewa; Odeku, Mojisola

    2017-12-11

    Maternal mortality ratio in Nigeria is among the highest in the world with an estimated 160 women dying every day of complications related to pregnancy and childbirth. In addition to appropriate management of complications related to pregnancy and childbirth, preventing unwanted pregnancies is an effective way to reduce maternal deaths. Identifying potentially modifiable factors associated with the achievement of fertility intentions is critical for developing behavior change interventions that will contribute to reducing maternal mortality. The data analyzed came from a longitudinal design with data collected in 2010/2011 and 2014 from the same group of women of reproductive age in six Nigerian cities. The data were collected as part of efforts to evaluate the effects of the Nigerian Urban Reproductive Health Initiative (NURHI). A total of 10,672 women were interviewed at the two points in time but the analyses in this manuscript were limited to 1921 in-union women who reported that they desired no more children at baseline in 2010/2011. The principal analytic method was multivariable regression adjusted for clustering at the enumeration area level. The analysis controlled for socio-demographic and household variables, ideational characteristics, and contraceptive use at baseline. About two thirds of the women who desired no more children at baseline have neither had any children nor were pregnant at endline. The strongest predictors of the achievement of fertility intentions include parity, age, religion, residence, spousal communication about family size, perceived severity of another pregnancy, and spousal agreement about family size. A comprehensive strategy to help women avoid unwanted pregnancies should include efforts to increase women's understanding about effective ways to prevent unplanned pregnancies and strengthen self-efficacy for contraceptive use. Promoting spousal communication about reproductive issues, engaging men, promoting smaller family sizes

  19. Risk of Developing Diabetes Among Refugees and Immigrants: A Longitudinal Analysis.

    Science.gov (United States)

    Berkowitz, Seth A; Fabreau, Gabriel E; Raghavan, Sridharan; Kentoffio, Katherine; Chang, Yuchiao; He, Wei; Atlas, Steven J; Percac-Lima, Sanja

    2016-12-01

    To determine the difference in risk of developing diabetes for refugees, immigrants, and American-born participants living in the same communities, and to explore potential mediators of that difference. Retrospective longitudinal cohort from January 1, 2003 and December 31, 2013. Refugees aged ≥18 years were matched in a 1:3 ratio by age, gender, and date of care initiation to (1) Spanish-speaking non-refugee immigrants, and (2) English-speaking controls receiving care in the same community health center. We used proportional hazards regression to estimate the risk of incident diabetes. We tested whether differences in education or baseline obesity mediated diabetes risk using counterfactual mediation analysis. We included 3174 participants. Among refugee participants, the most common countries of origin were Somalia (17.8 %), Iraq (16.7 %) and Bhutan (8.8 %). Diabetes incidence rate was 1.94, 1.91, and 1.22 cases per 100 person-years follow-up for refugees, immigrants, and controls, respectively. In adjusted models, both refugee (HR 2.08 95 % CI 1.32-3.30) and immigrant (HR 1.51 95 % CI 1.01-2.24) statuses were associated with increased diabetes risk compared with controls. Risk between refugees and immigrants did not differ (adjusted HR for refugees 1.37 95 % CI 0.91-2.06). In mediation analyses, educational attainment mediated 36 % (p = 0.007) of the difference in diabetes risk between refugees/immigrants and controls. Baseline obesity did not mediate difference in diabetes risk (proportion mediated 1 %, p = 0.84). Refugees and immigrants had significantly increased risk for diabetes, partially mediated by education. Education-based lifestyle interventions may be a promising strategy to prevent diabetes for these vulnerable patients.

  20. Eating frequency in relation to BMI in very young children: a longitudinal analysis.

    Science.gov (United States)

    Taylor, Rachael W; Iosua, Ella; Heath, Anne-Louise M; Gray, Andrew R; Taylor, Barry J; Lawrence, Julie A; Hanna, Maha; Cameron, Sonya L; Sayers, Rachel; Galland, Barbara

    2017-06-01

    Eating less frequently is associated with increased obesity risk in older children but data are potentially confounded by reverse causation, where bigger children eat less often in an effort to control their weight. Longitudinal data, particularly in younger children, are scarce. We aimed to determine whether eating frequency (meals and snacks) at 2 years of age is associated with past, current or subsequent BMI. Cohort analysis of a randomised controlled trial. Eating frequency at 2 years of age was estimated using 48 h diaries that recorded when each child ate meals and snacks (parent-defined) in five-minute blocks. Body length/height and weight were measured at 1, 2 and 3·5 years of age. Linear regression assessed associations between the number of eating occasions and BMI Z-score, before and after adjustment for potential confounding variables. Prevention of Overweight in Infancy (POI) study, Dunedin, New Zealand. Children (n 371) aged 1-3·5 years. On average, children ate 5·5 (sd 1·2) times/d at 2 years of age, with most children (88-89 %) eating 4-7 times/d. Eating frequency at 2 years was not associated with current (difference in BMI Z-score per additional eating occasion; 95 % CI: -0·02; -0·10, 0·05) or subsequent change (0·02; -0·03, 0·06) in BMI. Similarly, BMI at age 1 year did not predict eating frequency at 2 years of age (difference in eating frequency per additional BMI Z-score unit; 95 % CI: -0·03; -0·19, 0·13). Number of eating occasions per day was not associated with BMI in young children in the present study.

  1. Time course of neck-shoulder pain among workers: A longitudinal latent class growth analysis.

    Science.gov (United States)

    Hallman, David M; Rasmussen, Charlotte D Nørregaard; Jørgensen, Marie Birk; Holtermann, Andreas

    2018-01-01

    Objectives The aims of this study were to (i) identify trajectories of neck-shoulder pain (NSP) over one year in an occupational population and (ii) determine whether these trajectories are predicted by NSP characteristics as well as personal and occupational factors at baseline. Methods This longitudinal study was conducted among Danish workers (N=748) from 2012-2014. Text messages were used to collect frequent data on NSP over one year (14 waves in total). Peak NSP intensity in the past month was rated on a 0-10 numeric scale. A baseline questionnaire covered NSP characteristics (pain intensity, duration, comorbidity, pain medication, and pain interference) as well as personal (age, gender, body mass index) and occupational (seniority, work type, physical strain at work) factors. Latent class growth analysis was used to distinguish trajectories of NSP. Multivariate regression models with odds ratios (OR) were constructed to predict trajectories of NSP. Results Six distinct trajectories of NSP were identified (asymptomatic 11%, very low NSP 10%, low recovering NSP 18%, moderate recovering NSP 28%, strong fluctuating NSP 24% and severe persistent NSP 9% of the workers). Female gender, age, physical strain at work, NSP intensity and duration, pain medication, and pain interference in daily work at baseline were positively associated with severe persistent NSP and strong fluctuating NSP (all P<0.05). Altogether, personal and occupational factors accounted for 14% of the variance, while NSP characteristics accounted for 54%. Conclusions In an occupational sample, six distinct trajectories of NSP were identified. Physical strain at work appears to be a pertinent occupational factor predicting strong fluctuating and severe persistent NSP.

  2. Longitudinal analysis of the lung microbiota of cynomolgous macaques during long-term SHIV infection.

    Science.gov (United States)

    Morris, Alison; Paulson, Joseph N; Talukder, Hisham; Tipton, Laura; Kling, Heather; Cui, Lijia; Fitch, Adam; Pop, Mihai; Norris, Karen A; Ghedin, Elodie

    2016-07-08

    Longitudinal studies of the lung microbiome are challenging due to the invasive nature of sample collection. In addition, studies of the lung microbiome in human disease are usually performed after disease onset, limiting the ability to determine early events in the lung. We used a non-human primate model to assess lung microbiome alterations over time in response to an HIV-like immunosuppression and determined impact of the lung microbiome on development of obstructive lung disease. Cynomolgous macaques were infected with the SIV-HIV chimeric virus SHIV89.6P. Bronchoalveolar lavage fluid samples were collected pre-infection and every 4 weeks for 53 weeks post-infection. The microbiota was characterized at each time point by 16S ribosomal RNA (rRNA) sequencing. We observed individual variation in the composition of the lung microbiota with a proportion of the macaques having Tropheryma whipplei as the dominant organism in their lungs. Bacterial communities varied over time both within and between animals, but there did not appear to be a systematic alteration due to SHIV infection. Development of obstructive lung disease in the SHIV-infected animals was characterized by a relative increase in abundance of oral anaerobes. Network analysis further identified a difference in community composition that accompanied the development of obstructive disease with negative correlations between members of the obstructed and non-obstructed groups. This emphasizes how species shifts can impact multiple other species, potentially resulting in disease. This study is the first to investigate the dynamics of the lung microbiota over time and in response to immunosuppression in a non-human primate model. The persistence of oral bacteria in the lung and their association with obstruction suggest a potential role in pathogenesis. The lung microbiome in the non-human primate is a valuable tool for examining the impact of the lung microbiome in human health and disease.

  3. Three measures of physical rehabilitation effectiveness in elderly patients: a prospective, longitudinal, comparative analysis.

    Science.gov (United States)

    Sánchez-Rodríguez, Dolores; Miralles, Ramon; Muniesa, Josep M; Mojal, Sergio; Abadía-Escartín, Anna; Vázquez-Ibar, Olga

    2015-10-29

    Rehabilitation success is measured by instruments that assess performance of activities of daily living. Guidelines on the use and choice of these instruments are lacking. The present study aimed to analyse prognostic indicators of physical rehabilitation effectiveness in elderly patients according to three rehabilitation impact indices. Prospective, longitudinal study in a post-acute care unit. The study included rehabilitation-eligible deconditioned elderly in-patients prospectively admitted to post-acute care (n = 685, aged 83.2 ± 8.3 years, mean length of stay 15 ± 9.2 days). Premorbid health status variables (PHSV): age, sex, comorbidity (Charlson index), medical history (heart failure, pulmonary disease, cerebrovascular disease, dementia), previous living situation and pre-admission functional status (premorbid Lawton and Barthel indices). Admission health status variables (AHSV): main diagnoses, referral source, physical (Barthel-adm) and cognitive function (Pfeiffer test), undernutrition and dysphagia. Absolute functional gain (AFG, admission-to-discharge Barthel change), relative functional gain (RFG, achieved percentage of potential gain) and rehabilitation efficiency index (REI, AFG over length of stay). Univariate analysis considered these parameters, along with PHSV and AHSV. Multivariate logistic regression analysis was performed for AFG ≥20, RFG ≥35 % and REI ≥ 0.50. Greater AFG was associated with 14 variables, 8 PHSV (57.1 %) and 6 AHSV (42.8 %); greater RFG with 9 variables, 3 PHSV (33.3 %) and 6 AHSV (66.6 %); and REI with 9 variables, 4 PHSV (44.4 %) and 5 AHSV (55.5 %). Mean AFG value was 34.5 ± 15.8 in patients who achieved complete recovery (RFG 100 %, n = 189, 27.5 %) and 35.3 ± 15.0 (p = 0.593) in the remaining patients (n = 311, 45.4 %). In multivariate analysis, only Barthel-adm was related to all three rehabilitation impact indices. Both premorbid and acute-process variables have

  4. Sex difference in immune response to vaccination: A participant-level meta-analysis of randomized trials of IMVAMUNE smallpox vaccine.

    Science.gov (United States)

    Troy, Jesse D; Hill, Heather R; Ewell, Marian G; Frey, Sharon E

    2015-10-05

    Previous research shows immune response to vaccination differs by sex but this has not been explored for IMVAMUNE, a replication-deficient smallpox vaccine developed in response to the potential for bioterrorism using smallpox. We conducted a participant-level meta-analysis (N=275, 136 men, 139 women) of 3 randomized trials of IMVAMUNE conducted at 13 centers in the US through a federally-funded extramural research program. Studies were eligible for inclusion if they tested the standard dose (1×10(8)TCID₅₀/mL on Days 0 and 28) of liquid formulation IMVAMUNE, were completed at the time of our search, and enrolled healthy vaccinia-naïve participants. Models of the peak log₂ ELISA and PRNT titers post-second vaccination were constructed for each study with sex as a covariate. Results from these models were combined into random effects meta-analyses of the sex difference in response to IMVAMUNE. We then compared this approach with fixed effects models using the combined participant level data. In each study the mean peak log₂ ELISA titer was higher in men than women but no single study demonstrated a statistically significant difference. Combination of the adjusted study-specific estimates into the random effects model showed a higher mean peak log₂-titer in men compared with women (absolute difference [men-women]: 0.32, 95% CI: 0.02-0.60). Fixed effects models controlling for study showed a similar result (log₂ ELISA titer, men-women: 0.34, 95% CI: 0.04-0.63). This equates to a geometric mean peak titer that is approximately 27% higher in men than women (95% CI: 3-55%). Peak log₂ PRNT titers were also higher (although not significantly) in men (men-women: 0.14, 95% CI: -0.30 to 0.58). Our results show statistically significant differences in response to IMVAMUNE comparing healthy, vaccinia-naïve men with women and suggest that sex should be considered in further development and deployment of IMVAMUNE and other MVA-based vaccines. Copyright © 2015

  5. Expected utility of voluntary vaccination in the middle of an emergent Bluetongue virus serotype 8 epidemic: a decision analysis parameterized for Dutch circumstances.

    Science.gov (United States)

    Sok, J; Hogeveen, H; Elbers, A R W; Velthuis, A G J; Oude Lansink, A G J M

    2014-08-01

    In order to put a halt to the Bluetongue virus serotype 8 (BTV-8) epidemic in 2008, the European Commission promoted vaccination at a transnational level as a new measure to combat BTV-8. Most European member states opted for a mandatory vaccination campaign, whereas the Netherlands, amongst others, opted for a voluntary campaign. For the latter to be effective, the farmer's willingness to vaccinate should be high enough to reach satisfactory vaccination coverage to stop the spread of the disease. This study looked at a farmer's expected utility of vaccination, which is expected to have a positive impact on the willingness to vaccinate. Decision analysis was used to structure the vaccination decision problem into decisions, events and payoffs, and to define the relationships among these elements. Two scenarios were formulated to distinguish farmers' mindsets, based on differences in dairy heifer management. For each of the scenarios, a decision tree was run for two years to study vaccination behaviour over time. The analysis was done based on the expected utility criterion. This allows to account for the effect of a farmer's risk preference on the vaccination decision. Probabilities were estimated by experts, payoffs were based on an earlier published study. According to the results of the simulation, the farmer decided initially to vaccinate against BTV-8 as the net expected utility of vaccination was positive. Re-vaccination was uncertain due to less expected costs of a continued outbreak. A risk averse farmer in this respect is more likely to re-vaccinate. When heifers were retained for export on the farm, the net expected utility of vaccination was found to be generally larger and thus was re-vaccination more likely to happen. For future animal health programmes that rely on a voluntary approach, results show that the provision of financial incentives can be adjusted to the farmers' willingness to vaccinate over time. Important in this respect are the decision

  6. Vaccination coverage among adults, excluding influenza vaccination - United States, 2013.

    Science.gov (United States)

    Williams, Walter W; Lu, Peng-Jun; O'Halloran, Alissa; Bridges, Carolyn B; Kim, David K; Pilishvili, Tamara; Hales, Craig M; Markowitz, Lauri E

    2015-02-06

    Vaccinations are recommended throughout life to prevent vaccine-preventable diseases and their sequelae. Adult vaccination coverage, however, remains low for most routinely recommended vaccines and below Healthy People 2020 targets. In October 2014, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2015. With the exception of influenza vaccination, which is recommended for all adults each year, other adult vaccinations are recommended for specific populations based on a person's age, health conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess vaccination coverage among adults aged ≥19 years for selected vaccines, CDC analyzed data from the 2013 National Health Interview Survey (NHIS). This report highlights results of that analysis for pneumococcal, tetanus toxoid-containing (tetanus and diphtheria vaccine [Td] or tetanus and diphtheria with acellular pertussis vaccine [Tdap]), hepatitis A, hepatitis B, herpes zoster (shingles), and human papillomavirus (HPV) vaccines by selected characteristics (age, race/ethnicity,† and vaccination indication). Influenza vaccination coverage estimates for the 2013-14 influenza season have been published separately. Compared with 2012, only modest increases occurred in Tdap vaccination among adults aged ≥19 years (a 2.9 percentage point increase to 17.2%), herpes zoster vaccination among adults aged ≥60 years (a 4.1 percentage point increase to 24.2%), and HPV vaccination among males aged 19-26 years (a 3.6 percentage point increase to 5.9%); coverage among adults in the United States for the other vaccines did not improve. Racial/ethnic disparities in coverage persisted for all six vaccines and widened for Tdap and herpes zoster vaccination. Increases in vaccination coverage are needed to reduce the occurrence of vaccine-preventable diseases among adults. Awareness of the need for vaccines for adults is low

  7. A content analysis of news coverage of the HPV vaccine by U.S. newspapers, January 2002-June 2005.

    Science.gov (United States)

    Calloway, Crystal; Jorgensen, Cynthia M; Saraiya, Mona; Tsui, Jennifer

    2006-09-01

    Genital Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Of the 100 HPV types, HPV type 16 and HPV type 18 have been demonstrated to cause cervical cancer. Two pharmaceutical manufacturers have developed and tested HPV vaccines and are applying to the FDA for licensure. This research describes the content of HPV vaccine information contained in news articles. The Lexis-Nexis database was used to identify 25 articles on HPV that were published in 285 U.S. newspapers from January 1, 2003 to June 17, 2005. The coding schema captured information about the news event and source, as well as HPV and cervical cancer, transmission, vaccine, potential impact of the vaccine, and its relationship to PAP tests. The content analysis revealed that the news coverage of HPV vaccine provides information on the experimental status and efficacy of the vaccine, explains link between HPV and cervical cancer, and reports the manufacturers by name, as well as relies on them for a news source. Detailed information about HPV, however, was frequently missing which could lead to an incomplete picture or lack of understanding of the complexity of HPV and cervical cancer. As a major source of medical information, the media can be particularly important in educating policy makers and the general public about new scientific advances. Public health officials may wish to collaborate with journalists, health educators, healthcare providers, and women's health advocates to ensure that future educational initiatives explain the complexity of the association of HPV and cervical cancer and to stress the importance of continued cervical cancer screening.

  8. Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

    Science.gov (United States)

    Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

    2012-05-01

    The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on

  9. Emerging Vaccine Informatics

    Science.gov (United States)

    He, Yongqun; Rappuoli, Rino; De Groot, Anne S.; Chen, Robert T.

    2010-01-01

    Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO) has been initiated to integrate various vaccine data and support automated reasoning. PMID:21772787

  10. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time-trend analysis

    OpenAIRE

    Kaye, James A; Melero-Montes, Maria del Mar; Jick, Hershel

    2001-01-01

    Objectives To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. Design Time-trend analysis of data from the UK general practice research database. Setting General practices in the United Kingdom. Participants Children aged 12 years or younger diagnosed with autism between 1988 and 1999, with further analysis of boys aged 2 to 5 years born between 1988 and 1993. Main outcome measures Annual and age-specific incidence for ...

  11. Public Health Workers and Vaccination Coverage in Eastern China: A Health Economic Analysis

    Directory of Open Access Journals (Sweden)

    Yu Hu

    2014-05-01

    Full Text Available Background: Vaccine-preventable diseases cause more than one million deaths among children under 5 years of age every year. Public Health Workers (PHWs are needed to provide immunization services, but the role of human resources for public health as a determinant of vaccination coverage at the population level has not been assessed in China. The objective of this study was to test whether PHW density was positively associated with childhood vaccination coverage in Zhejiang Province, East China. Methods: The vaccination coverage rates of Measles Containing Vaccine (MCV, Diphtheria, Tetanus and Pertussis combined vaccine (DTP, and Poliomyelitis Vaccine (PV were chosen as the dependent variables. Vaccination coverage data of children aged 13–24 months for each county in Zhejiang Province were taken from the Zhejiang Immunization Information System (ZJIIS. Aggregate PHW density was an independent variable in one set of regressions, and Vaccine Personnel (VP and other PHW densities were used separately in another set. Data on densities of PHW and VP were taken from a national investigation on EPI launched by Ministry of Health of China in 2013. We controlled other determinants that may influence the vaccination coverage like Gross Domestic Product (GDP per person, proportion of migrant children aged <7 years, and land area. These data were taken from Zhejiang Provincial Bureau of Statistics and ZJIIS. Results: PHW density was significantly influence the coverage rates of MCV [Adjusted Odds Ratio(AOR = 4.29], DTP3(AOR = 2.16, and PV3 (AOR = 3.30. However, when the effects of VPs and other PHWs were assessed separately, we found that VP density was significantly associated with coverage of all three vaccinations (MCV AOR = 7.05; DTP3 AOR = 1.82; PV3 AOR = 4.83, while other PHW density was not. Proportion of migrant children < 7 years and Land area were found as negative and significant determinants for vaccination coverage, while GDP per person had

  12. Longitudinal Fracture Analysis of a Two-Dimensional Functionally Graded Beam

    Science.gov (United States)

    Rizov, V.

    2017-11-01

    Longitudinal fracture in a two-dimensional functionally graded beam is analyzed. The modulus of elasticity varies continuously in the beam cross-section. The beam is clamped in its right-hand end. The external loading consists of one longitudinal force applied at the free end of the lower crack arm. The longitudinal crack is located in the beam mid-plane. The fracture is studied in terms of the strain energy release rate. The solution derived is used to elucidate the effects of material gradients along the height as well as along the width of the beam cross-section on the fracture behaviour. The results obtained indicate that the fracture in two-dimensional functionally graded beams can be regulated efficiently by employing appropriate material gradients.

  13. Databases and in silico tools for vaccine design.

    Science.gov (United States)

    He, Yongqun; Xiang, Zuoshuang

    2013-01-01

    In vaccine design, databases and in silico tools play different but complementary roles. Databases collect experimentally verified vaccines and vaccine components, and in silico tools provide computational methods to predict and design new vaccines and vaccine components. Vaccine-related databases include databases of vaccines and vaccine components. In the USA, the Food and Drug Administration (FDA) maintains a database of licensed human vaccines, and the US Department of Agriculture keeps a database of licensed animal vaccines. Databases of vaccine clinical trials and vaccines in research also exist. The important vaccine components include vaccine antigens, vaccine adjuvants, vaccine vectors, and -vaccine preservatives. The vaccine antigens can be whole proteins or immune epitopes. Various in silico vaccine design tools are also available. The Vaccine Investigation and Online Information Network (VIOLIN; http://www.violinet.org ) is a comprehensive vaccine database and analysis system. The VIOLIN database includes various types of vaccines and vaccine components. VIOLIN also includes Vaxign, a Web-based in silico vaccine design program based on the reverse vaccinology strategy. Vaccine information and resources can be integrated with Vaccine Ontology (VO). This chapter introduces databases and in silico tools that facilitate vaccine design, especially those in the VIOLIN system.

  14. A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression.

    Science.gov (United States)

    Puccio, Francis; Fuller-Tyszkiewicz, Matthew; Ong, Deborah; Krug, Isabel

    2016-05-01

    Undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers. A systematic review was conducted on 42 studies that assessed the longitudinal relationship between eating pathology and depression. Of these 42 studies, multilevel random-effects meta-analyses were conducted on 30 eligible studies. Meta-analysis results showed that eating pathology was a risk factor for depression (rm  = 0.13) and that depression was a risk factor for eating pathology (rm  = 0.16). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms, and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were "present"/"absent") versus a continuous measure. Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis and bulimic symptoms on depression was significantly stronger for younger participants. Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs. Llevar a cabo un meta-análisis para proporcionar una síntesis cuantitativa de los estudios longitudinales que evaluaron la dirección de los efectos entre la alimentación patológica y la depresión. Un segundo objetivo fue utilizar la meta-regresión para dar cuenta de la heterogeneidad en términos de modificadores del efecto a nivel de estudio. MÉTODO: Una revisión sistemática se llevó a cabo en 42 estudios que evaluaron la relación longitudinal entre la alimentación patológica y la depresión. De

  15. Analysis of the proton longitudinal structure function from the gluon distribution function

    Energy Technology Data Exchange (ETDEWEB)

    Boroun, G.R.; Rezaei, B. [Razi University, Physics Department, Kermanshah (Iran, Islamic Republic of)

    2012-11-15

    We make a critical, next-to-leading order, study of the relationship between the longitudinal structure function F{sub L} and the gluon distribution proposed in Cooper-Sarkar et al. (Z. Phys. C 39:281, 1988; Acta Phys. Pol. B 34:2911 2003), which is frequently used to extract the gluon distribution from the proton longitudinal structure function at small x. The gluon density is obtained by expanding at particular choices of the point of expansion and compared with the hard Pomeron behavior for the gluon density. Comparisons with H1 data are made and predictions for the proposed best approach are also provided. (orig.)

  16. Feasibility of Identifying a Female Sex Worker Cohort at High Risk of HIV Infection in the Caribbean for HIV Vaccine Efficacy Trials: Longitudinal Results of HVTN 907.

    Science.gov (United States)

    Deschamps, Marie M; Metch, Barbara; Morgan, Cecilia A; Zorilla, Carmen D; Donastorg, Yeycy; Swann, Edith; Taina, Dadaille; Patrice, Joseph; Pape, William J

    2016-01-01

    Identifying cohorts of Caribbean women with HIV infection rates sufficient for inclusion in HIV vaccine efficacy trials has been challenging. HVTN 907 determined the feasibility of identifying and retaining a cohort of women at high risk for HIV acquisition by focusing recruitment on female sex workers (FSWs). HIV uninfected FSWs, residing in Haiti, Dominican Republic, and Puerto Rico, who reported unprotected sex and met previously described more stringent site-specific eligibility criteria, were eligible. Behavioral risk assessment, HIV counseling and testing, and pregnancy testing were performed at baseline, 6, 12, and 18 months. Among 799 FSWs (264 from Dominican Republic, 334 from Haiti, and 201 from Puerto Rico), the median age was 26 years, with 54% having less than a high school education and 45% having a monthly household income of less than $US 100. Median number of male partners 6 months before screening was 200. Retention at 18 months was 93%. Twelve women became HIV infected, 9 from Haiti. The annualized HIV incidence was 1.07% (95% confidence interval: 0.55% to 1.87%). Pregnancy incidence was 22.5% (95% confidence interval: 21.9% to 29.5%). Statistically significant declines in risk behaviors occurred between screening and the 18-month visit assessment. The HVTN 907 study identified a high-risk cohort of women with excellent retention for all 3 sites, despite major challenges especially in Haiti. These results show that a bridging study of a vaccine shown to be efficacious in other clade settings would be possible among FSWs in the region, particularly in Haiti.

  17. Feasibility of Identifying a Female Sex Worker Cohort at High Risk of HIV Infection in the Caribbean for HIV Vaccine Efficacy Trials: Longitudinal Results of HVTN 907

    Science.gov (United States)

    Deschamps, Marie Marcelle; Metch, Barbara; Morgan, Cecilia A; Zorrilla, Carmen D; Donastorg, Yeycy; Swann, Edith; Taina, Dadaille; Patrice, Joseph; JW, Pape

    2015-01-01

    Background Identifying cohorts of Caribbean women with HIV infection rates sufficient for inclusion in HIV vaccine efficacy trials has been challenging. HVTN 907 determined the feasibility of identifying and retaining a cohort of women at high risk for HIV acquisition by focusing recruitment on female sex workers (FSW). Methods HIV uninfected FSWs, residing in Haiti, Dominican Republic (DR) and Puerto Rico (PR), who reported unprotected sex and met previously described more stringent site-specific eligibility criteria14, were eligible. Behavioral risk assessment, HIV counseling and testing and pregnancy testing were done at baseline, 6, 12, and 18 months. Results Among 799 FSWs (264 from DR, 334 from Haiti, 201 from PR), the median age was 26 years, with 54% having less than a high school education and 45% having a monthly household income of less than $US100. Median number of male partners six months prior to screening was 200. Retention at 18 months was 93%. Twelve women became HIV infected, nine from Haiti. The annualized HIV incidence was 1.07 % (95% CI 0.55%, 1.87%). Pregnancy incidence was 22.5% (95% CI 21.9, 29.5%). Statistically significant declines in risk behaviors occurred between screening and the 18 month visit assessment. Discussion The HVTN 907 study identified a high risk cohort of women with excellent retention for all 3 sites, despite major challenges especially in Haiti. These results show that a bridging study of a vaccine shown to be efficacious in other clade settings would be possible among FSW in the region, particularly in Haiti. PMID:26761272

  18. Identification of Molecular Signatures from Different Vaccine Adjuvants in Chicken by Integrative Analysis of Microarray Data

    Directory of Open Access Journals (Sweden)

    Duk Kyung Kim

    2016-07-01

    Full Text Available The present study compared the differential functions of two groups of adjuvants, Montanide incomplete Seppic adjuvant (ISA series and Quil A, cholesterol, dimethyl dioctadecyl ammonium bromide, and Carbopol (QCDC formulations, in chicken by analyzing published microarray data associated with each type of vaccine adjuvants. In the biological function analysis for differentially expressed genes altered by two different adjuvant groups, ISA series and QCDC formulations showed differential effects when chickens were immunized with a recombinant immunogenic protein of Eimeria. Among the biological functions, six categories were modified in both adjuvant types. However, with respect to “Response to stimulus”, no biological process was modified by the two adjuvant groups at the same time. The QCDC adjuvants showed effects on the biological processes (BPs including the innate immune response and the immune response to the external stimulus such as toxin and bacterium, while the ISA adjuvants modified the BPs to regulate cell movement and the response to stress. In pathway analysis, ISA adjuvants altered the genes involved in the functions related with cell junctions and the elimination of exogenous and endogenous macromolecules. The analysis in the present study could contribute to the development of precise adjuvants based on molecular signatures related with their immunological functions.

  19. [Travelers' vaccines].

    Science.gov (United States)

    Ouchi, Kazunobu

    2011-09-01

    The number of Japanese oversea travelers has gradually increased year by year, however they usually pay less attention to the poor physical condition at the voyage place. Many oversea travelers caught vaccine preventable diseases in developing countries. The Vaccine Guideline for Oversea Travelers 2010 published by Japanese Society of Travel Health will be helpful for spreading the knowledge of travelers' vaccine and vaccine preventable diseases in developing countries. Many travelers' vaccines have not licensed in Japan. I hope these travelers' vaccines, such as typhoid vaccine, meningococcal vaccine, cholera vaccine and so on will be licensed in the near future.

  20. Analysis of variola and vaccinia virus neutralization assays for smallpox vaccines.

    Science.gov (United States)

    Hughes, Christine M; Newman, Frances K; Davidson, Whitni B; Olson, Victoria A; Smith, Scott K; Holman, Robert C; Yan, Lihan; Frey, Sharon E; Belshe, Robert B; Karem, Kevin L; Damon, Inger K

    2012-07-01

    Possible smallpox reemergence drives research for third-generation vaccines that effectively neutralize variola virus. A comparison of neutralization assays using different substrates, variola and vaccinia (Dryvax and modified vaccinia Ankara [MVA]), showed significantly different 90% neutralization titers; Dryvax underestimated while MVA overestimated variola neutralization. Third-generation vaccines may rely upon neutralization as a correlate of protection.

  1. Analysis of H7 avian influenza viruses by antigenic cartography and correlation to protection by vaccination

    Science.gov (United States)

    The H7 hemagglutinin subtype one of the most common subtypes of avian influenza virus (AIV) in poultry world wide and since it has the potential to become highly pathogenic it is among the priority subtypes for vaccination. Selection of the optimal vaccine seed strains may now be aided by antigenic...

  2. Analysis of Seasonal Influenza Vaccine Uptake among Children and Adolescents with an Intellectual Disability

    Science.gov (United States)

    Yen, Chia-Feng; Hsu, Shang-Wei; Loh, Ching-Hui; Fang, Wen-Hui; Wu, Chia-Ling; Chu, Cordia M.; Lin, Jin-Ding

    2012-01-01

    The aim of the present study was to describe the seasonal influenza vaccination rate and to examine its determinants for children and adolescents with intellectual disabilities (ID) living in the community. A cross-sectional survey was conducted to analyze the data on seasonal influenza vaccination rate among 1055 ID individuals between the ages…

  3. Immunoproteomic analysis of the antibody response obtained in tilapia following immunization with a Streptococcus iniae vaccine

    Science.gov (United States)

    Streptococcus iniae is one of the most economically important Gram-positive pathogens in cultured fish species worldwide. Research has shown that vaccination is a tool that can be used in the prevention of streptococcal disease. The USDA-ARS patented S. iniae vaccine has been demonstrated to be ef...

  4. Optimization on machine learning based approaches for sentiment analysis on HPV vaccines related tweets.

    Science.gov (United States)

    Du, Jingcheng; Xu, Jun; Song, Hsingyi; Liu, Xiangyu; Tao, Cui

    2017-03-03

    Analysing public opinions on HPV vaccines on social media using machine learning based approaches will help us understand the reasons behind the low vaccine coverage and come up with corresponding strategies to improve vaccine uptake. To propose a machine learning system that is able to extract comprehensive public sentiment on HPV vaccines on Twitter with satisfying performance. We collected and manually annotated 6,000 HPV vaccines related tweets as a gold standard. SVM model was chosen and a hierarchical classification method was proposed and evaluated. Additional feature sets evaluation and model parameters optimization was done to maximize the machine learning model performance. A hierarchical classification scheme that contains 10 categories was built to access public opinions toward HPV vaccines comprehensively. A 6,000 annotated tweets gold corpus with Kappa annotation agreement at 0.851 was created and made public available. The hierarchical classification model with optimized feature sets and model parameters has increased the micro-averaging and macro-averaging F score from 0.6732 and 0.3967 to 0.7442 and 0.5883 respectively, compared with baseline model. Our work provides a systematical way to improve the machine learning model performance on the highly unbalanced HPV vaccines related tweets corpus. Our system can be further applied on a large tweets corpus to extract large-scale public opinion towards HPV vaccines.

  5. Increases in synthetic cannabinoids-related harms: Results from a longitudinal web-based content analysis.

    Science.gov (United States)

    Lamy, Francois R; Daniulaityte, Raminta; Nahhas, Ramzi W; Barratt, Monica J; Smith, Alan G; Sheth, Amit; Martins, Silvia S; Boyer, Edward W; Carlson, Robert G

    2017-06-01

    Synthetic Cannabinoid Receptor Agonists (SCRA), also known as "K2" or "Spice," have drawn considerable attention due to their potential of abuse and harmful consequences. More research is needed to understand user experiences of SCRA-related effects. We use semi-automated information processing techniques through eDrugTrends platform to examine SCRA-related effects and their variations through a longitudinal content analysis of web-forum data. English language posts from three drug-focused web-forums were extracted and analyzed between January 1st 2008 and September 30th 2015. Search terms are based on the Drug Use Ontology (DAO) created for this study (189 SCRA-related and 501 effect-related terms). EDrugTrends NLP-based text processing tools were used to extract posts mentioning SCRA and their effects. Generalized linear regression was used to fit restricted cubic spline functions of time to test whether the proportion of drug-related posts that mention SCRA (and no other drug) and the proportion of these "SCRA-only" posts that mention SCRA effects have changed over time, with an adjustment for multiple testing. 19,052 SCRA-related posts (Bluelight (n=2782), Forum A (n=3882), and Forum B (n=12,388)) posted by 2543 international users were extracted. The most frequently mentioned effects were "getting high" (44.0%), "hallucinations" (10.8%), and "anxiety" (10.2%). The frequency of SCRA-only posts declined steadily over the study period. The proportions of SCRA-only posts mentioning positive effects (e.g., "High" and "Euphoria") steadily decreased, while the proportions of SCRA-only posts mentioning negative effects (e.g., "Anxiety," 'Nausea," "Overdose") increased over the same period. This study's findings indicate that the proportion of negative effects mentioned in web forum posts and linked to SCRA has increased over time, suggesting that recent generations of SCRA generate more harms. This is also one of the first studies to conduct automated content analysis

  6. Association of serum anti-rotavirus immunoglobulin A antibody seropositivity and protection against severe rotavirus gastroenteritis: analysis of clinical trials of human rotavirus vaccine.

    Science.gov (United States)

    Cheuvart, Brigitte; Neuzil, Kathleen M; Steele, A Duncan; Cunliffe, Nigel; Madhi, Shabir A; Karkada, Naveen; Han, Htay Htay; Vinals, Carla

    2014-01-01

    Clinical trials of the human rotavirus vaccine Rotarix™ (RV1) have demonstrated significant reductions in severe rotavirus gastroenteritis (RVGE) in children worldwide. However, no correlate of vaccine efficacy (VE) has yet been established. This paper presents 2 analyses which aimed to investigate whether serum anti-RV IgA measured by ELISA 1 or 2 mo post-vaccination can serve as a correlate of efficacy against RVGE: (1) In a large Phase III efficacy trial (Rota-037), the Prentice criteria for surrogate endpoints was applied to anti-RV IgA seropositivity 1 mo post-vaccination. These criteria determine whether a significant vaccine group effect can be predicted from the surrogate, namely seropositivity (anti-RV IgA concentration>20 U/mL); (2) Among other GSK-sponsored RV1 VE studies, 8 studies which assessed immunogenicity at 1 or 2 mo post-vaccination in all or a sub-cohort of enrolled subjects and had at least 10 RVGE episodes were included in a meta-analysis to measure the regression between clinical VE and VE predicted from immunogenicity (VE1). In Rota-037, anti-RV IgA seropositivity post-vaccination was associated with a lower incidence of any or severe RVGE, however, the proportion of vaccine group effect explained by seropositivity was only 43.6% and 32.7% respectively. This low proportion was due to the vaccine group effect observed in seronegative subjects. In the meta-analysis, the slope of the regression between clinical VE and VE1 was statistically significant. These two independent analyses support the hypothesis that post-vaccination anti-RV IgA seropositivity (antibody concentration ≥20 U/mL) may serve as a useful correlate of efficacy in clinical trials of RV1 vaccines.

  7. Influenza vaccines licensed in the United States in healthy children: a systematic review and network meta-analysis (Protocol

    Directory of Open Access Journals (Sweden)

    Prutsky Gabriela J

    2012-12-01

    Full Text Available Abstract Background Influenza is an acute respiratory illness caused by influenza viruses, which occurs in epidemics worldwide every year. Children are an important target for prevention methods, including vaccination. While evidence about the decision on whether to vaccinate healthy children is robust, evidence supporting the decision of which of available vaccines to use remains unclear. This review will summarize the evidence about the efficacy and safety of the available vaccines for seasonal influenza licensed in the United States for use in healthy children. Methods/design An umbrella systematic review (SR and network meta-analysis will be conducted of randomized controlled trials (RCTs. We will search for SRs to identify parallel RCTs evaluating inactive and/or live attenuated influenza vaccines licensed in the United States for use in healthy children to prevent influenza. Subsequently, we will update the literature search of the selected SRs to the present time to capture recent controlled studies. To complement the work focused on harms, we will also select observational studies focusing on post marketing retrospective studies. Inclusion will not be limited by language, publication date or publication status. To identify additional candidate studies, we will review the reference lists of the eligible primary studies and narrative reviews; we will query the expert members of the Advisory Committee on Immunization Practices and review references from their previous statement. Additionally, we will review the reports from the Institute of Medicine on the adverse effects of vaccines. Two reviewers will independently determine study eligibility and will extract descriptive, methodological (using the Cochrane risk of bias tool for RCTs and the Newcastle–Ottawa scale for observational studies and efficacy data. When possible, we will conduct meta-analyses and network meta-analyses by combining indirect and direct comparisons. We will

  8. Vaccination against Clostridium difficile using toxin fragments: Observations and analysis in animal models.

    Science.gov (United States)

    Spencer, Janice; Leuzzi, Rosanna; Buckley, Anthony; Irvine, June; Candlish, Denise; Scarselli, Maria; Douce, Gillian R

    2014-01-01

    Clostridium difficile is a major cause of antibiotic associated diarrhea. Recently, we have shown that effective protection can be mediated in hamsters through the inclusion of specific recombinant fragments from toxin A and B in a systemically delivered vaccine. Interestingly while neutralizing antibodies to the binding domains of both toxin A and B are moderately protective, enhanced survival is observed when fragments from the glucosyltransferase region of toxin B replace those from the binding domain of this toxin. In this addendum, we discuss additional information that has been derived from such vaccination studies. This includes observations on efficacy and cross-protection against different ribotypes mediated by these vaccines and the challenges that remain for a vaccine which prevents clinical symptoms but not colonization. The use and value of vaccination both in the prevention of infection and for treatment of disease relapse will be discussed.

  9. Survival analysis for predictive factors of delay vaccination in Iranian children

    Directory of Open Access Journals (Sweden)

    Abolfazl Mohammadbeigi

    2015-01-01

    Full Text Available Background: Today, beside immunization coverage the age appropriate vaccination is another helpful index in public health. Evidences have shown that high immunization coverage rates do not necessarily imply age-appropriate vaccination status. The current study aimed to show the predictive factors of delayed vaccination by survival models. Methods: A historical cohort study conducted on 3610 children aged between 24 and 47 months who was living in the suburbs of five big cities of Iran. Time of delay in vaccination of first dose of mumps-measles-rubella (MMR was calculated from date of vaccination minus age appropriate time according to vaccine card. Kaplan-Maier and Log rank tests were used for comparison the median of delay time. For controlling of confounding variables, multivariate cox model was used and hazard ratio with 95% confidence interval (95% was reported. Results: The mean ± standard deviation and median interquartile range of delay time was 38.34 ± 73.1 and 16 (11-31 days in delayed group. The Log rank test showed that city of living, nationality, parents′ education, and birth order are related with prolonged delay time in MMR vaccination (P 0.05. Cox regression showed that city of living, mother education, and nationality are the most predictive factors of delay time duration in MMR vaccination. Conclusions: Delay time duration of vaccination increased by faring from capital to the east south. Moreover, concentration of foreign immigrants in big cities and low level of mother education are the most predictors of delayed vaccination. Educational intervention should focus on immigrants and mothers with low education level.

  10. Does influenza vaccination improve pregnancy outcome? Methodological issues and research needs.

    Science.gov (United States)

    Savitz, David A; Fell, Deshayne B; Ortiz, Justin R; Bhat, Niranjan

    2015-11-25

    Evidence that influenza vaccination during pregnancy is safe and effective at preventing influenza disease in women and their children through the first months of life is increasing. Several reports of reduced risk of adverse outcomes associated with influenza vaccination have generated interest in its potential for improving pregnancy outcome. Gavi, the Vaccine Alliance, estimates maternal influenza immunization programs in low-income countries would have a relatively modest impact on mortality compared to other new or under-utilized vaccines, however the impact would be substantially greater if reported vaccine effects on improved pregnancy outcomes were accurate. Here, we examine the available evidence and methodological issues bearing on the relationship between influenza vaccination and pregnancy outcome, particularly preterm birth and fetal growth restriction, and summarize research needs. Evidence for absence of harm associated with vaccination at a point in time is not symmetric with evidence of benefit, given the scenario in which vaccination reduces risk of influenza disease and, in turn, risk of adverse pregnancy outcome. The empirical evidence for vaccination preventing influenza in pregnant women is strong, but the evidence that influenza itself causes adverse pregnancy outcomes is inconsistent and limited in quality. Studies of vaccination and pregnancy outcome have produced mixed evidence of potential benefit but are limited in terms of influenza disease assessment and control of confounding, and their analytic methods often fail to fully address the longitudinal nature of pregnancy and influenza prevalence. We recommend making full use of results of randomized trials, re-analysis of existing observational studies to account for confounding and time-related factors, and quantitative assessment of the potential benefits of vaccination in improving pregnancy outcome, all of which should be informed by the collective engagement of experts in influenza

  11. Evolution of the Conceptions of a Secondary Education Biology Teacher: Longitudinal Analysis Using Cognitive Maps

    Science.gov (United States)

    Da-Silva, Consuelo; Mellado, Vicente; Ruiz, Constantino; Porlan, Rafael

    2007-01-01

    We describe a longitudinal study of a secondary education biology teacher at two moments in her career (1993-2002), determining the changes in her conceptions of the nature of science and its teaching and learning, and the factors that favored or hindered such changes. The changes were analyzed using cognitive maps, constructed on the basis of the…

  12. Longitudinal multigroup invariance analysis of the satisfaction with food-related life scale in university students

    DEFF Research Database (Denmark)

    Schnettler, Berta; Miranda, Horacio; Miranda-Zapata, Edgardo

    2017-01-01

    This study examined longitudinal measurement invariance in the Satisfaction with Food-related Life (SWFL) scale using follow-up data from university students. We examined this measure of the SWFL in different groups of students, separated by various characteristics. Through non-probabilistic long...

  13. Longitudinal Analysis of Chinese High School Student's Stress in School and Academic Achievement

    Science.gov (United States)

    Liu, Yangyang; Lu, Zuhong

    2011-01-01

    In previous research, few studies have examined the effects of adolescents' stress in school on the change rates of their academic achievement. In the present study, we seek to examine the longitudinal relationships between adolescents' stress in school and the change rates of their academic achievement. The results indicated that for those whose…

  14. Longitudinal Analysis of Links between Bullying Victimization and Psychosomatic Maladjustment in Swedish Schoolchildren

    Science.gov (United States)

    Hellfeldt, Karin; Gill, Peter Edward; Johansson, Björn

    2018-01-01

    Cross-sectional studies of bullying mask variability in categories of and persistence of bullying victimization. Longitudinal, individual-level data offers a greater insight into schoolchildren's psychosomatic maladjustment as a consequence of bullying. Swedish schoolchildren (n = 3,349), with unique identifiers, in 44 schools (4th-9th grade),…

  15. The Friendships of Young Children with Developmental Delays: A Longitudinal Analysis

    Science.gov (United States)

    Guralnick, Michael J.; Neville, Brian; Hammond, Mary A.; Connor, Robert T.

    2007-01-01

    This longitudinal study examined the social interactions of children with mild developmental (cognitive) delays with friends across the early childhood and early elementary years. Results revealed increases in many forms of social exchange with effect sizes in the moderate range, but no changes in sustained interactive play. Social interaction…

  16. A Sexual Selection Theory Longitudinal Analysis of Sexual Segregation and Integration in Early Adolescence.

    Science.gov (United States)

    Pellegrini, Anthony D.; Long, Jeffrey D.

    2003-01-01

    This longitudinal study examined the ways middle school peer groups become sexually integrated and the factors that predict dating popularity. Findings indicated that although groups did not become more integrated with time, changes in peer group sexual integration co-varied with dating popularity. Findings also showed that dominance-related…

  17. Temperament, Parenting, and South Korean Early Adolescents' Physical Aggression: A Five-Wave Longitudinal Analysis

    Science.gov (United States)

    Lee, Julie

    2014-01-01

    Objective: This study examined the growth pattern in physical aggression over a five-year period among South Korean early adolescents and the effects of temperament (anger/frustration and emotion regulation) and parenting (harsh parenting and parental monitoring) on early adolescents' physical aggression. Design: A five-year longitudinal design…

  18. School Sector Differences in Student Achievement in Australian Primary and Secondary Schools: A Longitudinal Analysis

    Science.gov (United States)

    Marks, Gary N.

    2015-01-01

    This article examines school sector differences in student performance Years 3, 5, and 7 in numeracy, reading, writing, spelling and grammar using data from the Longitudinal Study of Australian Children and the national testing program (NAPLAN). At each of the 3 Year levels, there are sizable school sector differences with students from…

  19. Self-Control and Early Adolescent Antisocial Behavior: A Longitudinal Analysis

    Science.gov (United States)

    de Kemp, Raymond A. T.; Vermulst, Ad A.; Finkenauer, Catrin; Scholte, Ron H. J.; Overbeek, Geertjan; Rommes, Els W. M.; Engels, Rutger C. M. E.

    2009-01-01

    The article discusses a three-wave longitudinal study that investigates the relationship between self-control and aggressive and delinquent behavior of early adolescent boys and girls. The sample consists of 1,012 Dutch adolescents (mean age = 12.3) in their first year of secondary education. Structural equation modeling analyses reveal that high…

  20. Why item response theory should be used for longitudinal questionnaire data analysis in medical research

    NARCIS (Netherlands)

    Gorter, Rosalie; Fox, Gerardus J.A.; Twisk, Jos W.R.

    2015-01-01

    Background Multi-item questionnaires are important instruments for monitoring health in epidemiological longitudinal studies. Mostly sum-scores are used as a summary measure for these multi-item questionnaires. The objective of this study was to show the negative impact of using sum-score based

  1. Longitudinal analysis of flexibility and reorganization in early adolescence: A dynamic systems study of family interactions

    NARCIS (Netherlands)

    Granic, I.; Hollenstein, T.P.; Dishion, T.J.; Patterson, G.R.

    2003-01-01

    A dynamic systems (DS) approach was used to study changes in the structure of family interactions during the early adolescent transition period. Longitudinal observational data were collected in 5 waves prior to, during, and after the transition. Boys (n = 149 families) were videotaped problem

  2. Unconventional Word Segmentation in Emerging Bilingual Students' Writing: A Longitudinal Analysis

    Science.gov (United States)

    Sparrow, Wendy

    2014-01-01

    This study explores cross-language and longitudinal patterns in unconventional word segmentation in 25 emerging bilingual students' (Spanish/English) writing from first through third grade. Spanish and English writing samples were collected annually and analyzed for two basic types of unconventional word segmentation: hyposegmentation, in…

  3. Predictors of Changes in Weight Esteem among Mainland Chinese Adolescents: A Longitudinal Analysis

    Science.gov (United States)

    Chen, Hong; Jackson, Todd

    2009-01-01

    Weight and body image concerns are prevalent among adolescents across cultures and pose significant threats to well-being, yet there is a paucity of longitudinal research on samples living in non-Western and developing countries. This prospective study assessed the extent to which select sociocultural, psychological, and biological risk factors…

  4. Implicit, Stand-Alone or Integrated Skills Education for Undergraduates: A Longitudinal Analysis of Programme Outcomes

    Science.gov (United States)

    MacVaugh, Jason; Jones, Anna; Auty, Stephanie

    2014-01-01

    This paper reports the findings of a longitudinal investigation into the effectiveness of skills education programmes within business and management undergraduate degree courses. During the period between 2005 and 2011, a large business school in the south-west of England was developed and implemented two distinct approaches to skills education.…

  5. A Longitudinal Analysis of an Out-of-School Science Experience

    Science.gov (United States)

    Knapp, Doug

    2007-01-01

    A phenomenological approach was used to investigate the longitudinal recollections of participants of an out-of-school science program. The experience was a field trip to the Shenandoah National Park (USA) conducted in the fall of 2004. The science topic was geologic history and features related to the Shenandoah Valley. Two major themes relating…

  6. Influence analysis for skew-normal semiparametric joint models of multivariate longitudinal and multivariate survival data.

    Science.gov (United States)

    Tang, An-Min; Tang, Nian-Sheng; Zhu, Hongtu

    2017-04-30

    The normality assumption of measurement error is a widely used distribution in joint models of longitudinal and survival data, but it may lead to unreasonable or even misleading results when longitudinal data reveal skewness feature. This paper proposes a new joint model for multivariate longitudinal and multivariate survival data by incorporating a nonparametric function into the trajectory function and hazard function and assuming that measurement errors in longitudinal measurement models follow a skew-normal distribution. A Monte Carlo Expectation-Maximization (EM) algorithm together with the penalized-splines technique and the Metropolis-Hastings algorithm within the Gibbs sampler is developed to estimate parameters and nonparametric functions in the considered joint models. Case deletion diagnostic measures are proposed to identify the potential influential observations, and an extended local influence method is presented to assess local influence of minor perturbations. Simulation studies and a real example from a clinical trial are presented to illustrate the proposed methodologies. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Forms and Functions of Aggression in Adolescent Friendship Selection and Influence : A Longitudinal Social Network Analysis

    NARCIS (Netherlands)

    Sijtsema, Jelle J.; Ojanen, Tiina; Veenstra, Rene; Lindenberg, Siegwart; Hawley, Patricia H.; Little, Todd D.

    Aggressive children are known to have friends. However, less is known about the impact of aggression on friendship development and how this can differ for overt and relational (i.e., the forms) and instrumental and reactive (i.e., the functions) aggression. This longitudinal study utilized the forms

  8. A Longitudinal Analysis of Language Generalization among Adolescents with Severely Handicapping Conditions.

    Science.gov (United States)

    Warren, Steven F.; Rogers-Warren, Ann K.

    1983-01-01

    A longitudinal study of generalized effects of a language training program on the structural aspects of six severely retarded institutionalized adolescents' productive language revealed a strong relationship between the length of the trained forms and generalization. This effect was related to Ss' mean length of utterance. (Author/CL)

  9. Self-control and early adolescent antisocial behavior : a longitudinal analysis

    NARCIS (Netherlands)

    Kemp, R.A.T. de; Vermulst, A.A.; Finkenauer, C.; Scholte, R.H.J.; Overbeek, G.J.; Rommes, E.W.M.

    2009-01-01

    The article discusses a three-wave longitudinal study that investigates the relationship between self-control and aggressive and delinquent behavior of early adolescent boys and girls. The sample consists of 1,012 Dutch adolescents (mean age = 12.3) in their first year of secondary education.

  10. Forms and Functions of Aggression in Adolescent Friendship Selection and Influence: A Longitudinal Social Network Analysis

    Science.gov (United States)

    Sijtsema, Jelle J.; Ojanen, Tiina; Veenstra, Rene; Lindenberg, Siegwart; Hawley, Patricia H.; Little, Todd D.

    2010-01-01

    Aggressive children are known to have friends. However, less is known about the impact of aggression on friendship development and how this can differ for overt and relational (i.e., the forms) and instrumental and reactive (i.e., the functions) aggression. This longitudinal study utilized the forms and functions perspective on aggression to…

  11. Numerical Analysis on Longitudinal Location Optimization of Vortex Generator in Compact Heat Exchangers

    DEFF Research Database (Denmark)

    Gorji, M.; Mirgolbababei, H.; Barari, Amin

    2011-01-01

    In this paper, numerical, curvilinear and turbulent model has been used to investigate the effect of vortex generator's longitudinal displacement on heat transfer and fluid flow in different Reynolds numbers ranging from 500 to 3000. The numerical model has been validated with experimental results...

  12. Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis.

    Science.gov (United States)

    Lytras, Theodore; Kopsachilis, Frixos; Mouratidou, Elisavet; Papamichail, Dimitris; Bonovas, Stefanos

    2016-03-03

    Influenza vaccination is recommended for healthcare workers (HCWs), but coverage is often low. We reviewed studies evaluating interventions to increase seasonal influenza vaccination coverage in HCWs, including a meta-regression analysis to quantify the effect of each component. Fourty-six eligible studies were identified. Domains conferring a high risk of bias were identified in most studies. Mandatory vaccination was the most effective intervention component (Risk Ratio of being unvaccinated [RRunvacc] = 0.18, 95% CI: 0.08-0.45), followed by "soft" mandates such as declination statements (RRunvacc = 0.64, 95% CI: 0.45-0.92), increased awareness (RRunvacc = 0.83, 95% CI: 0.71-0.97) and increased access (RRunvacc = 0.88, 95% CI: 0.78-1